Healthcare Provider Details

I. General information

NPI: 1043141070
Provider Name (Legal Business Name): PLAYFUL PATHS PEDIATRIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 S DILLARD ST
WINTER GARDEN FL
34787-3559
US

IV. Provider business mailing address

447 PUMA LOOP
GROVELAND FL
34736-3507
US

V. Phone/Fax

Practice location:
  • Phone: 561-460-6113
  • Fax:
Mailing address:
  • Phone: 561-460-6113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUMMER SQUILLACIOTI
Title or Position: OWNER
Credential: OTD
Phone: 561-460-6113