Provider Demographics
NPI:1558689026
Name:LIBERTY KIDS INC
Entity Type:Organization
Organization Name:LIBERTY KIDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:786-201-7051
Mailing Address - Street 1:50 NE 128TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4512
Mailing Address - Country:US
Mailing Address - Phone:786-201-7051
Mailing Address - Fax:786-329-6010
Practice Address - Street 1:50 NE 128TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4512
Practice Address - Country:US
Practice Address - Phone:786-201-7051
Practice Address - Fax:786-329-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-09
Last Update Date:2022-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1558689026Medicaid