Provider Demographics
NPI:1922549062
Name:KIDS R KOOL, INC
Entity Type:Organization
Organization Name:KIDS R KOOL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SIERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-418-0336
Mailing Address - Street 1:4148 W 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4107
Mailing Address - Country:US
Mailing Address - Phone:305-418-0336
Mailing Address - Fax:305-456-3563
Practice Address - Street 1:4148 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4107
Practice Address - Country:US
Practice Address - Phone:305-418-0336
Practice Address - Fax:305-456-3563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPP299601033140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric