MEDICARE: KIDS PLUS SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1114625365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIDS PLUS SERVICES INC

Provider Business Mailing Address
First Line	:	1640 HIGHLAND DR
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-4534
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1640 HIGHLAND DR
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-4534
Country	:	US
Telephone Number	:	407-504-1080
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTOPHER JOHN STAWIARZ
Credential	:
Telephone Number	:	407-504-1080

Provider Enumeration Date	:	02/17/2023
Last Update Date	:	02/17/2023

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Directions to “KIDS PLUS SERVICES INC ” Practice Location

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