MEDICARE: KIDS R KIDS THERAPY SERVICES, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2251P0200X	Pediatric Physical Therapist
2	235Z00000X	Speech-Language Pathologist
3	225XP0200X	Pediatric Occupational Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235176488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIDS R KIDS THERAPY SERVICES, INC.

Provider Business Mailing Address
First Line	:	400 NE 30TH ST
Second Line	:
City	:	WILTON MANORS
State	:	FL
Zip	:	33334-2053
Country	:	US
Telephone Number	:	954-564-7885
Fax Number	:	954-564-1175

Provider Business Practice Location Address
First Line	:	400 NE 30TH ST
Second Line	:
City	:	WILTON MANORS
State	:	FL
Zip	:	33334-2053
Country	:	US
Telephone Number	:	954-564-7885
Fax Number	:	954-564-1175

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KELLI FURTON
Credential	:	OTR/L
Telephone Number	:	954-564-7885

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	09/08/2008

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1942341276 — JEFFREY SHEARER LCSW
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