Provider Demographics
NPI:1821156076
Name:PEDIATRIC PHYSICAL THERAPY KIDS ON THE MOVE
Entity Type:Organization
Organization Name:PEDIATRIC PHYSICAL THERAPY KIDS ON THE MOVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SENESAC
Authorized Official - Suffix:
Authorized Official - Credentials:PT, PHD, PCS
Authorized Official - Phone:352-373-7337
Mailing Address - Street 1:KIDS ON THE MOVE 1203 NW 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601
Mailing Address - Country:US
Mailing Address - Phone:352-373-7337
Mailing Address - Fax:352-377-3622
Practice Address - Street 1:1203 NW 16TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601
Practice Address - Country:US
Practice Address - Phone:352-373-7337
Practice Address - Fax:352-377-3622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27032251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty