MEDICARE: WII CARE KIDS THERAPY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1043084320
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WII CARE KIDS THERAPY INC

Provider Business Mailing Address
First Line	:	13595 SW 134TH AVE STE 204
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-4580
Country	:	US
Telephone Number	:	305-588-9424
Fax Number	:

Provider Business Practice Location Address
First Line	:	13595 SW 134TH AVE STE 204
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-4580
Country	:	US
Telephone Number	:	305-588-9424
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AVILETTE BRETO-GONZALEZ
Credential	:
Telephone Number	:	305-588-9424

Provider Enumeration Date	:	11/08/2023
Last Update Date	:	11/08/2023

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