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General NPI Number Information
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NPI Number | 1922549062
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Entity Type | Organization
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Legal Business Name | KIDS R KOOL, INC
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Dates
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Enumeration Date | 03/08/2017
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Last Update Date | 03/08/2017
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Provider Practice Location Address
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Address Line | 4148 W 12TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4107
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Country | US
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Telephone | 305-418-0336
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Fax | 305-456-3563
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Provider Business Mailing Address
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Address Line | 4148 W 12TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4107
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Country | US
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Telephone | 305-418-0336
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Fax | 305-456-3563
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Authorized Official
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Title or Position | CEO
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Name | MR. LEONARDO SIERRA
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Credential |
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Telephone | 305-418-0336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | PP29960103
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License Number State | FL
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