Healthcare Provider Details

I. General information

NPI: 1730749771
Provider Name (Legal Business Name): HAPPY KIDS THERAPY PEDIATRIC CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7872 W FLAGLER ST
MIAMI FL
33144-2304
US

IV. Provider business mailing address

7872 W FLAGLER ST
MIAMI FL
33144-2304
US

V. Phone/Fax

Practice location:
  • Phone: 786-360-5029
  • Fax: 786-360-5379
Mailing address:
  • Phone: 786-285-7103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: GLENYS AURORA RODRIGUEZ
Title or Position: OT
Credential: OTR/L
Phone: 786-285-7103