Healthcare Provider Details

I. General information

NPI: 1194677377
Provider Name (Legal Business Name): KIDSWAY THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2904 S JOG RD
GREENACRES FL
33467-2002
US

IV. Provider business mailing address

2904 S JOG RD
GREENACRES FL
33467-2002
US

V. Phone/Fax

Practice location:
  • Phone: 561-517-8227
  • Fax: 561-491-2272
Mailing address:
  • Phone: 561-517-8227
  • Fax: 561-491-2272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: BEATRIZ RODRIGUEZ
Title or Position: GENERAL COORDINATOR
Credential:
Phone: 561-517-8227