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General NPI Number Information
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NPI Number | 1205598158
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Entity Type | Organization
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Legal Business Name | VIP KIDZ BOYNTON BEACH LLC
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Dates
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Enumeration Date | 10/07/2021
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 2500 QUANTUM LAKES DR STE 212
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8308
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Country | US
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Telephone | 786-486-9513
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Fax |
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Provider Business Mailing Address
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Address Line | 4 HARVARD CIR
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-1991
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIA MANTILLA
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Credential |
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Telephone | 786-486-9513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM3000X
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Taxonomy Name | Medically Fragile Infants and Children Day Care
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License Number |
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License Number State |
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