MEDICARE: ALL ABOUT KIDS HOME THERAPY 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	2251P0200X	Pediatric Physical Therapist	PT20230	FL

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	:	1245607035
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL ABOUT KIDS HOME THERAPY SERVICES, INC

Provider Business Mailing Address
First Line	:	3801 S KENWOOD AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-1523
Country	:	US
Telephone Number	:	813-504-6699
Fax Number	:	813-253-3113

Provider Business Practice Location Address
First Line	:	3801 S KENWOOD AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-1523
Country	:	US
Telephone Number	:	813-504-6699
Fax Number	:	813-253-3113

Authorized Official
Title or Position	:	OWNER
Name	:	AMY L BRUN
Credential	:	MPT
Telephone Number	:	813-504-6699

Provider Enumeration Date	:	08/27/2015
Last Update Date	:	08/27/2015

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