Healthcare Provider Details
I. General information
NPI: 1982942207
Provider Name (Legal Business Name): KIDS CHOICE PEDIATRIC DAY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/21/2013
Last Update Date: 01/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7900 NW 27TH AVE SUITE D-5
MIAMI FL
33147-4909
US
IV. Provider business mailing address
4767 NW 9TH DR
PLANTATION FL
33317-1470
US
V. Phone/Fax
- Phone: 786-476-7100
- Fax: 786-476-7031
- Phone: 754-204-6122
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM3000X |
| Taxonomy | Medically Fragile Infants and Children Day Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JEFFREY
LOUIS-CHARLES
Title or Position: ADMINISTRATOR
Credential:
Phone: 754-204-6122