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General NPI Number Information
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NPI Number | 1003253337
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Entity Type | Organization
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Legal Business Name | SOUTH MIAMI LEARNING CENTER
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Dates
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Enumeration Date | 05/28/2013
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Last Update Date | 05/28/2013
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Provider Practice Location Address
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Address Line | 7800 SW 57TH AVE SUITE 228
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5528
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Country | US
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Telephone | 305-665-4999
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Fax | 305-665-0332
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Provider Business Mailing Address
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Address Line | 7800 SW 57TH AVE SUITE 228
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5528
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Country | US
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Telephone | 305-665-4999
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Fax | 305-665-0332
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Authorized Official
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Title or Position | CHIEF FINANCIAL AND OPERATIONS OFC
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Name | MR. LUIS ANTONIO RIVERA
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Credential | MBA
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Telephone | 305-665-4999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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Taxonomy #3
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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Taxonomy #5
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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Taxonomy #6
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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Taxonomy #7
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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Taxonomy #8
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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Taxonomy #9
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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Taxonomy #10
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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Taxonomy #11
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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Taxonomy #12
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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Taxonomy #13
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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Taxonomy #14
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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Taxonomy #15
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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