Organization
SUNSHINY MENTAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHAJA CHISTY MD (OWNER)
(248) 987-8117
Entity
Organization
Contact information
Practice address
19330 SW 69TH ST, FORT LAUDERDALE, FL 33332-1652
(754) 666-1911
(888) 958-5968
Mailing address
PO BOX 451959, SUNRISE, FL 33345-1959
(720) 515-9112
(888) 958-5968
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
ME109705
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130080684
DRIVERS LICENSE
CO
Enumeration date
11/22/2013
Last updated
09/20/2018
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