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General NPI Number Information
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NPI Number | 1518368471
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Entity Type | Organization
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Legal Business Name | VIP KIDZ LLC
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Dates
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Enumeration Date | 09/10/2014
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 2500 METROCENTRE BLVD SUITE 1
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-3107
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Country | US
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Telephone | 561-223-2673
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Fax | 561-634-3903
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Provider Business Mailing Address
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Address Line | 2500 METROCENTRE BLVD SUITE 1
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-3107
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Country | US
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Telephone | 561-223-2673
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Fax | 561-634-3903
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MARIA A 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 | 60081008
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License Number State | FL
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