Provider Demographics
NPI:1275793754
Name:KIDSZONE DEVELOPMENTAL AND LANGUAGE CENTER
Entity Type:Organization
Organization Name:KIDSZONE DEVELOPMENTAL AND LANGUAGE CENTER
Other - Org Name:JOAN RIVERA TORO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIVERA TORO
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:787-413-8068
Mailing Address - Street 1:URB. RIBERAS DEL RIO F8 CALLE 6
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-413-8068
Mailing Address - Fax:787-731-3420
Practice Address - Street 1:1055 MARGINAL KENNEDY EDIFICIO ILA
Practice Address - Street 2:411-A
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-1715
Practice Address - Country:US
Practice Address - Phone:787-413-8068
Practice Address - Fax:787-731-3420
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIDSZONE DEVELOPMENTAL AND LANGUAGE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-10
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
PR1096225X00000X
PR456235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1871684399OtherNPI