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General NPI Number Information
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NPI Number | 1629619564
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Entity Type | Organization
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Legal Business Name | KID'S SPOT
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Dates
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Enumeration Date | 10/02/2019
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Last Update Date | 10/02/2019
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Provider Practice Location Address
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Address Line | 1 OAKWOOD BLVD STE 130
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City | HOLLYWOOD
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State | FL
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Zip | 33020-1937
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Country | US
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Telephone | 954-925-3844
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Fax |
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Provider Business Mailing Address
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Address Line | 1 OAKWOOD BLVD STE 130
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City | HOLLYWOOD
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State | FL
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Zip | 33020-1937
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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 | SPEECH-LANGUAGE PATHOLOGIST
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Name | ISABELLA ZUMMO
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Credential | CF-SLP
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Telephone | 216-406-6493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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