Provider Demographics
NPI:1518710078
Name:PRECIOUS KIDDOS THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:PRECIOUS KIDDOS THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITHE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE BERNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-945-1170
Mailing Address - Street 1:427 LADY DIANA DR FL USA
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-7678
Mailing Address - Country:US
Mailing Address - Phone:321-945-1170
Mailing Address - Fax:863-268-2004
Practice Address - Street 1:7490 CYPRESS GARDENS BLVD
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-4104
Practice Address - Country:US
Practice Address - Phone:321-945-1170
Practice Address - Fax:863-268-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy