=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750771887
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PLAY IT WRITE KIDS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2015
-----------------------------------------------------
Last Update Date | 01/27/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10230 SW 87TH ST
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33173-3930
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-632-1466
-----------------------------------------------------
Fax | 305-595-7388
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10230 SW 87TH ST
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33173-3930
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-632-1466
-----------------------------------------------------
Fax | 305-595-7388
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. CHRISTINA ELAINE PHINNEY
-----------------------------------------------------
Credential | OTR/L
-----------------------------------------------------
Telephone | 305-632-1466
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225XP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Occupational Therapist
-----------------------------------------------------
License Number | OT8982
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------