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General NPI Number Information
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NPI Number | 1710378906
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Entity Type | Organization
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Legal Business Name | GREEN APPLE PEDIATRIC THERAPY, INC
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Dates
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Enumeration Date | 02/10/2015
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 15715 S DIXIE HWY SUITE 218
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City | MIAMI
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State | FL
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Zip | 33157-1800
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Country | US
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Telephone | 305-985-2977
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Fax | 877-977-4957
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Provider Business Mailing Address
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Address Line | 917 NW 128TH PL
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City | MIAMI
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State | FL
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Zip | 33182-2319
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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 | PRESIDENT
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Name | LAURA DONOVAN
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Credential |
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Telephone | 347-326-1776
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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 | 11218
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License Number State | FL
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