Provider Demographics
NPI:1932480928
Name:KIDS SPEECH,PHYSICAL, AND OCCUPATIONAL THERAPY, INC
Entity Type:Organization
Organization Name:KIDS SPEECH,PHYSICAL, AND OCCUPATIONAL THERAPY, INC
Other - Org Name:KIDS S.P.O.T.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:954-445-3064
Mailing Address - Street 1:1955 N FEDERAL HWY
Mailing Address - Street 2:STE 253
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1028
Mailing Address - Country:US
Mailing Address - Phone:954-580-2520
Mailing Address - Fax:954-580-2521
Practice Address - Street 1:1955 N FEDERAL HWY
Practice Address - Street 2:STE 253
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1028
Practice Address - Country:US
Practice Address - Phone:954-580-2520
Practice Address - Fax:954-580-2521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-02
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 19446225100000X
FLOT10949225X00000X
FLSA 3927235Z00000X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty