Healthcare Provider Details

I. General information

NPI: 1790601060
Provider Name (Legal Business Name): GROWTH 4 KIDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12499 BRANTLEY COMMONS CT STE 201
FORT MYERS FL
33907-5694
US

IV. Provider business mailing address

25204 CALUSA DR
PUNTA GORDA FL
33955-4068
US

V. Phone/Fax

Practice location:
  • Phone: 239-560-3392
  • Fax:
Mailing address:
  • Phone: 239-560-3392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KAREN KNUFFKE
Title or Position: MGRM
Credential: OT
Phone: 239-560-3392