Healthcare Provider Details

I. General information

NPI: 1598308868
Provider Name (Legal Business Name): SMALL GIANTS THERAPY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2019
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7331 W FLAGLER ST
MIAMI FL
33144-2505
US

IV. Provider business mailing address

60 SW 59TH AVE
MIAMI FL
33144-3327
US

V. Phone/Fax

Practice location:
  • Phone: 786-712-4963
  • Fax:
Mailing address:
  • Phone: 786-712-4963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: YUNAIDA LEYVA
Title or Position: PRESIDENT
Credential:
Phone: 786-712-4963