Sptlsc Inc

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

Legal business name

SPTLSC INC

Doing business as

Sunnyside Pediatric Therapy

Practice address

110 S Orange St
New Smyrna Beach, FL 32168-7153

Phone

(609) 432-8983

NPI assigned

Jun 20, 2024

Last updated

Aug 14, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matthew Ford Ford

Title

President

Phone

(609) 432-8983

Specialties & licenses 1

Addresses

Other names 1

• Sunnyside Pediatric Therapy Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1043054596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 SAND TRAP CT",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321243021",
            "telephone_number": "609-432-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S ORANGE ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687153",
            "telephone_number": "609-432-8983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPTLSC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "MATTHEW FORD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-432-8983"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunnyside Pediatric Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southeast Volusia Medical Services Inc (Bert Fish Medical Center)
• Southwest Mobility Inc. (Scooter Mobility Center)
• Skylur E Spalding
• Zachary Spolar, APRN
• Spruce Creek Assisted Living Facility , Inc.
• John A Stamm Jr., PHARMD
• Charles Maurice Steinmann
• Stellar Foot and Ankle Specialists LLC
• Erin Stephens, LGPC
• Phillip Lee Stephens, O.D.

• Developmental - Behavioral Pediatrics Physician in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Developmental - Behavioral Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.