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General NPI Number Information
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NPI Number | 1518710078
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Entity Type | Organization
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Legal Business Name | PRECIOUS KIDDOS THERAPY SERVICES LLC
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 7490 CYPRESS GARDENS BLVD
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City | WINTER HAVEN
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State | FL
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Zip | 33884-4104
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Country | US
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Telephone | 321-945-1170
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Fax | 863-268-2004
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Provider Business Mailing Address
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Address Line | 427 LADY DIANA DR FL USA
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City | DAVENPORT
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State | FL
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Zip | 33837-7678
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Country | US
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Telephone | 321-945-1170
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Fax | 863-268-2004
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Authorized Official
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Title or Position | OWNER
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Name | ANITHE PIERRE BERNARD
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Credential |
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Telephone | 321-945-1170
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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 |
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License Number State |
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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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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