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General NPI Number Information
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NPI Number | 1245006386
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Entity Type | Organization
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Legal Business Name | KIDZ MEDICAL PPEC SERVICES LLC
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Dates
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Enumeration Date | 11/29/2023
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 125 NE 168TH ST
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-3411
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Country | US
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Telephone | 786-910-5406
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Fax |
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Provider Business Mailing Address
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Address Line | 125 NE 168TH ST
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-3411
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Country | US
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Telephone | 786-910-5406
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Fax |
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Authorized Official
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Title or Position | AMBR
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Name | GUDELIA SALAZAR
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Credential |
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Telephone | 786-910-5406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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