Healthcare Provider Details

I. General information

NPI: 1417882796
Provider Name (Legal Business Name): FIRST PEDIATRIC THERAPY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7285 NW 173RD DR APT 102
HIALEAH FL
33015-8406
US

IV. Provider business mailing address

7285 NW 173RD DR APT 102
HIALEAH FL
33015-8406
US

V. Phone/Fax

Practice location:
  • Phone: 786-304-7217
  • Fax:
Mailing address:
  • Phone: 786-304-7217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MAYLIN LUJAN
Title or Position: PRESIDENT
Credential: BCBA
Phone: 786-304-7217