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General NPI Number Information
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NPI Number | 1134663867
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Entity Type | Organization
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Legal Business Name | AMAZING KIDZ THERAPY, PLLC
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Dates
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Enumeration Date | 12/14/2016
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 4312 BELL SHOALS RD
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City | VALRICO
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State | FL
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Zip | 33596-7171
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Country | US
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Telephone | 813-298-9298
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Fax |
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Provider Business Mailing Address
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Address Line | 687 W LUMSDEN RD
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City | BRANDON
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State | FL
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Zip | 33511-5911
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Country | US
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Telephone | 813-643-1389
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Fax | 813-315-6512
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Authorized Official
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Title or Position | CEO
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Name | KATHLEEN PICI
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Credential | OTR/L
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Telephone | 813-643-1389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT10626
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #4
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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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License Number State |
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