Provider Demographics
NPI:1891068912
Name:ALL4KIDSLLC
Entity Type:Organization
Organization Name:ALL4KIDSLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:HADDAD
Authorized Official - Last Name:COOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSOTR/L
Authorized Official - Phone:813-486-7728
Mailing Address - Street 1:7110 YARDLEY WAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1210
Mailing Address - Country:US
Mailing Address - Phone:813-486-7728
Mailing Address - Fax:
Practice Address - Street 1:7110 YARDLEY WAY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1210
Practice Address - Country:US
Practice Address - Phone:813-486-7728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11018225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL889783200Medicaid