Provider Demographics
NPI:1669841136
Name:LITTLE FOOT REHAB, INC.
Entity Type:Organization
Organization Name:LITTLE FOOT REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMOANO
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:786-316-5118
Mailing Address - Street 1:1966 NE 123RD ST
Mailing Address - Street 2:#220
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2868
Mailing Address - Country:US
Mailing Address - Phone:786-316-5118
Mailing Address - Fax:
Practice Address - Street 1:7941 EAST DR
Practice Address - Street 2:PH
Practice Address - City:NORTH BAY VILLAGE
Practice Address - State:FL
Practice Address - Zip Code:33141-3310
Practice Address - Country:US
Practice Address - Phone:305-321-6081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10808225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty