Healthcare Provider Details

I. General information

NPI: 1558689026
Provider Name (Legal Business Name): LIBERTY KIDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2010
Last Update Date: 02/27/2022
Certification Date: 02/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 NE 128TH ST
NORTH MIAMI FL
33161-4512
US

IV. Provider business mailing address

50 NE 128TH ST
NORTH MIAMI FL
33161-4512
US

V. Phone/Fax

Practice location:
  • Phone: 786-201-7051
  • Fax: 786-329-6010
Mailing address:
  • Phone: 786-201-7051
  • Fax: 786-329-6010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. TAMIKA ELIZABETH JONES
Title or Position: PRESIDENT/OWNER
Credential: MS.ED
Phone: 786-201-7051