Healthcare Provider Details
I. General information
NPI: 1982997508
Provider Name (Legal Business Name): EZ TALK 4 KIDZ CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/17/2011
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7220 NW 36TH ST STE 643
MIAMI FL
33166-6737
US
IV. Provider business mailing address
1871 NW SOUTH RIVER DR UNIT 1101
MIAMI FL
33125-2774
US
V. Phone/Fax
- Phone: 305-763-2384
- Fax: 305-508-4212
- Phone: 305-763-2384
- Fax: 305-508-4212
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0401X |
| Taxonomy | Comprehensive Outpatient Rehabilitation Facility (CORF) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
NOSLEN
SANCHEZ MESA
Title or Position: PRESIDENT
Credential:
Phone: 305-763-2384