Healthcare Provider Details

I. General information

NPI: 1477059632
Provider Name (Legal Business Name): LITTLE EINSTEIN'S THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 04/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15270 SW 103RD PL
MIAMI FL
33157-1446
US

IV. Provider business mailing address

15270 SW 103RD PL
MIAMI FL
33157-1446
US

V. Phone/Fax

Practice location:
  • Phone: 305-951-0747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. ANIELKA ORNER
Title or Position: PRESIDENT
Credential:
Phone: 305-951-0747