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General NPI Number Information
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NPI Number | 1033365101
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Entity Type | Organization
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Legal Business Name | CLOSING THE GAPS LEARNING CENTER
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Dates
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Enumeration Date | 08/08/2008
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Last Update Date | 08/08/2008
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Provider Practice Location Address
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Address Line | 2464 CORAL WAY
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City | CORAL GABLES
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State | FL
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Zip | 33145-3419
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Country | US
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Telephone | 305-854-3516
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Fax | 305-854-3518
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Provider Business Mailing Address
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Address Line | 2464 CORAL WAY
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City | CORAL GABLES
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State | FL
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Zip | 33145-3419
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Country | US
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Telephone | 305-854-3516
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Fax | 305-854-3518
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Authorized Official
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Title or Position | DIRECTOR OF PROGRAMS
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Name | EDNA P. CACERES
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Credential | M.ED.
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Telephone | 305-854-3516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 751660
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License Number State | FL
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