Provider Demographics
NPI:1699042747
Name:D'MEZA LITTLE SCHOLARS
Entity Type:Organization
Organization Name:D'MEZA LITTLE SCHOLARS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INFANT TODDLER DEVELOPMENTAL SPECIA
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:D'MEZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-268-4257
Mailing Address - Street 1:10181 NW 24TH COURT
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322
Mailing Address - Country:US
Mailing Address - Phone:954-268-4247
Mailing Address - Fax:
Practice Address - Street 1:10181 NW 24TH CT
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-2629
Practice Address - Country:US
Practice Address - Phone:954-268-4257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003592300Medicaid