Healthcare Provider Details

I. General information

NPI: 1235176488
Provider Name (Legal Business Name): KIDS R KIDS THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NE 30TH ST
WILTON MANORS FL
33334-2053
US

IV. Provider business mailing address

400 NE 30TH ST
WILTON MANORS FL
33334-2053
US

V. Phone/Fax

Practice location:
  • Phone: 954-564-7885
  • Fax: 954-564-1175
Mailing address:
  • Phone: 954-564-7885
  • Fax: 954-564-1175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KELLI FURTON
Title or Position: PRESIDENT
Credential: OTR/L
Phone: 954-564-7885