Healthcare Provider Details

I. General information

NPI: 1700703386
Provider Name (Legal Business Name): GROWING KIDS PEDIATRIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14160 PALMETTO FRNTG RD STE 115
MIAMI LAKES FL
33016-1641
US

IV. Provider business mailing address

14160 PALMETTO FRNTG RD STE 115
MIAMI LAKES FL
33016-1641
US

V. Phone/Fax

Practice location:
  • Phone: 786-483-7051
  • Fax:
Mailing address:
  • Phone: 786-483-7051
  • 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: YANET REAL SANCHEZ
Title or Position: OWNER
Credential:
Phone: 786-483-7051