Provider Demographics
NPI:1093207664
Name:MAGIKIDZ, INC
Entity Type:Organization
Organization Name:MAGIKIDZ, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ITDS/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-278-0623
Mailing Address - Street 1:6850 W 16TH DR APT 219
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4459
Mailing Address - Country:US
Mailing Address - Phone:786-278-0623
Mailing Address - Fax:305-602-8466
Practice Address - Street 1:6850 W 16TH DR APT 219
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014
Practice Address - Country:US
Practice Address - Phone:786-278-0623
Practice Address - Fax:305-602-8466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-30
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251P0200X, 225XP0200X, 235Z00000X
FL252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty