MEDICARE: WONDER STEPS THERAPY CORP

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	:	1912758426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WONDER STEPS THERAPY CORP

Provider Business Mailing Address
First Line	:	7900 OAK LN OFC 431
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-6000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7900 OAK LN OFC 431
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-6000
Country	:	US
Telephone Number	:	305-930-9708
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DAILYN HERNANDEZ GALLARDO
Credential	:
Telephone Number	:	786-213-5683

Provider Enumeration Date	:	04/01/2024
Last Update Date	:	07/17/2024

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Directions to “WONDER STEPS THERAPY CORP ” Practice Location

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