Healthcare Provider Details

I. General information

NPI: 1962336206
Provider Name (Legal Business Name): KIDS DREAM LEARNING CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 SIMPSON RD
KISSIMMEE FL
34744-4600
US

IV. Provider business mailing address

2840 WILLOWSEED LN
SAINT CLOUD FL
34772-9364
US

V. Phone/Fax

Practice location:
  • Phone: 321-443-6281
  • Fax:
Mailing address:
  • Phone: 321-443-6281
  • Fax: 321-443-6281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: GINA E LOPEZ
Title or Position: ADMINISTRATOR
Credential: M.ED, MS
Phone: 321-443-6281