Provider Demographics
NPI:1487003539
Name:AMAZING KIDZ EXTENDED CARE INC.
Entity Type:Organization
Organization Name:AMAZING KIDZ EXTENDED CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:YANEISY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-615-9400
Mailing Address - Street 1:9020 SW 137TH AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1427
Mailing Address - Country:US
Mailing Address - Phone:786-615-9400
Mailing Address - Fax:786-773-2868
Practice Address - Street 1:9000 SW 137TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1435
Practice Address - Country:US
Practice Address - Phone:786-615-9400
Practice Address - Fax:786-773-2868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-09
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL60081022252Y00000X
3140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
No252Y00000XAgenciesEarly Intervention Provider Agency