Provider Demographics
NPI:1790438968
Name:FREEDOM KIDS ACADEMY
Entity Type:Organization
Organization Name:FREEDOM KIDS ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EZEQUIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-850-2197
Mailing Address - Street 1:9825 MARINA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-6628
Mailing Address - Country:US
Mailing Address - Phone:561-826-3207
Mailing Address - Fax:
Practice Address - Street 1:9825 MARINA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-6628
Practice Address - Country:US
Practice Address - Phone:561-826-3207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty