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General NPI Number Information
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NPI Number | 1033402177
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Entity Type | Organization
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Legal Business Name | EARLY SUCCESS INC
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Dates
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Enumeration Date | 05/23/2011
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Last Update Date | 05/23/2011
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Provider Practice Location Address
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Address Line | 13973 SW 153RD TER
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City | MIAMI
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State | FL
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Zip | 33177-0926
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Country | US
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Telephone | 786-219-8245
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Fax | 786-242-0734
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Provider Business Mailing Address
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Address Line | 13973 SW 153RD TER
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City | MIAMI
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State | FL
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Zip | 33177-0926
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Country | US
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Telephone | 786-219-8245
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Fax | 786-242-0734
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NICHOLE NAGIM-DEWAR
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Credential | MS
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Telephone | 786-219-8245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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License Number State | FL
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