Healthcare Provider Details

I. General information

NPI: 1114373420
Provider Name (Legal Business Name): FLORIDA EARLY CHILDHOOD DEVELOPMENT ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2016
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 AVON RD
WEST PALM BEACH FL
33401-7808
US

IV. Provider business mailing address

812 AVON RD
WEST PALM BEACH FL
33401-7808
US

V. Phone/Fax

Practice location:
  • Phone: 917-202-9642
  • Fax: 561-584-5885
Mailing address:
  • Phone: 917-202-9642
  • Fax: 561-584-5885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. NEREYDA AQUINO
Title or Position: CEO
Credential:
Phone: 917-202-9642