Provider Demographics
NPI:1598280919
Name:KHAILA MONTESSORI ACADEMY
Entity Type:Organization
Organization Name:KHAILA MONTESSORI ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NEKESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-356-1079
Mailing Address - Street 1:9500 DUNHILL DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3974
Mailing Address - Country:US
Mailing Address - Phone:786-657-7419
Mailing Address - Fax:
Practice Address - Street 1:16101 NW 22ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33054-2049
Practice Address - Country:US
Practice Address - Phone:786-657-7419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL924Medicaid