Provider Demographics
NPI:1114373420
Name:FLORIDA EARLY CHILDHOOD DEVELOPMENT ALLIANCE
Entity Type:Organization
Organization Name:FLORIDA EARLY CHILDHOOD DEVELOPMENT ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NEREYDA
Authorized Official - Middle Name:
Authorized Official - Last Name:AQUINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-202-9642
Mailing Address - Street 1:1930 S DIXIE HWY UNIT R6
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-7728
Mailing Address - Country:US
Mailing Address - Phone:917-202-9642
Mailing Address - Fax:561-584-5885
Practice Address - Street 1:1930 S DIXIE HWY UNIT R6
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-7728
Practice Address - Country:US
Practice Address - Phone:917-202-9642
Practice Address - Fax:561-584-5885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty