Provider Demographics
NPI:1780825422
Name:MY BIG WORLD.INC
Entity Type:Organization
Organization Name:MY BIG WORLD.INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAPANES
Authorized Official - Suffix:
Authorized Official - Credentials:BS,SLPA- ITDS
Authorized Official - Phone:305-388-0004
Mailing Address - Street 1:9010 SW 137TH AVE
Mailing Address - Street 2:SUITE 242
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1413
Mailing Address - Country:US
Mailing Address - Phone:305-388-0004
Mailing Address - Fax:305-388-8009
Practice Address - Street 1:9010 SW 137TH AVE
Practice Address - Street 2:SUITE 242
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1413
Practice Address - Country:US
Practice Address - Phone:305-388-0004
Practice Address - Fax:305-388-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI 1242222Q00000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1780825422Medicaid
FL1770810566Medicaid