Healthcare Provider Details

I. General information

NPI: 1508942509
Provider Name (Legal Business Name): PRECIOUS THERAPY & REHAB CENTER FOR KIDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4160 W 16TH AVE SUITE 210 & 211
HIALEAH FL
33012-5853
US

IV. Provider business mailing address

4160 W 16TH AVE SUITE 210 & 211
HIALEAH FL
33012-5853
US

V. Phone/Fax

Practice location:
  • Phone: 305-207-2996
  • Fax: 305-207-2819
Mailing address:
  • Phone: 305-207-2996
  • Fax: 305-207-2819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. IDALMIS PERERA
Title or Position: PRESIDENT
Credential:
Phone: 305-207-2996