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General NPI Number Information
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NPI Number | 1811225634
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Entity Type | Organization
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Legal Business Name | KIDIATRIX THERAPY, INC.
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Dates
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Enumeration Date | 12/07/2009
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Last Update Date | 12/07/2009
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Provider Practice Location Address
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Address Line | 6614 SW 114TH PL UNIT B
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City | MIAMI
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State | FL
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Zip | 33173-1781
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Country | US
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Telephone | 305-491-3960
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Fax | 305-596-4676
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Provider Business Mailing Address
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Address Line | 6614 SW 114TH PL UNIT B
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City | MIAMI
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State | FL
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Zip | 33173-1781
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Country | US
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Telephone | 305-491-3960
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Fax | 305-596-4676
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Authorized Official
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Title or Position | DIRECTOR, PRESIDENT
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Name | AMY K. KELBLE
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Credential |
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Telephone | 305-491-3960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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