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NPI Code Detail

MEDICARE: KIDS R KOOL, INC

MEDICARE: KIDS R KOOL, 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
13140N1450XPediatric Skilled Nursing FacilityPP29960103FL

Other Identifiers

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

General Provider Information

NPI Number : 1922549062
Entity Type Code : Organization
Provider Name (Legal Business Name) : KIDS R KOOL, INC
Provider Business Mailing Address
First Line : 4148 W 12TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-4107
Country : US
Telephone Number : 305-418-0336
Fax Number : 305-456-3563
Provider Business Practice Location Address
First Line : 4148 W 12TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-4107
Country : US
Telephone Number : 305-418-0336
Fax Number : 305-456-3563
Authorized Official
Title or Position : CEO
Name : MR. LEONARDO SIERRA
Credential :
Telephone Number : 305-418-0336
Provider Enumeration Date : 03/08/2017
Last Update Date : 03/08/2017

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