Provider Demographics
NPI:1114794625
Name:ACTION KIDZ PPEC CORP
Entity Type:Organization
Organization Name:ACTION KIDZ PPEC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FELVINA
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:RENNA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-632-0926
Mailing Address - Street 1:4501 N WICKHAM RD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-7180
Mailing Address - Country:US
Mailing Address - Phone:321-241-0279
Mailing Address - Fax:888-429-6515
Practice Address - Street 1:4501 N WICKHAM RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-7180
Practice Address - Country:US
Practice Address - Phone:321-241-0279
Practice Address - Fax:888-429-6515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care