Provider Demographics
NPI:1902694813
Name:SUNRISE.SUNSETXO LLC
Entity type:Organization
Organization Name:SUNRISE.SUNSETXO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-858-9107
Mailing Address - Street 1:4663 NW 58TH CT
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-2769
Mailing Address - Country:US
Mailing Address - Phone:813-858-9107
Mailing Address - Fax:
Practice Address - Street 1:4663 NW 58TH CT
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-2769
Practice Address - Country:US
Practice Address - Phone:813-858-9107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies