Provider Demographics
NPI:1013609254
Name:MILESTONES CHILDREN'S THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:MILESTONES CHILDREN'S THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:MS SLP
Authorized Official - Phone:407-203-9492
Mailing Address - Street 1:1259 W COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-3108
Mailing Address - Country:US
Mailing Address - Phone:407-203-9492
Mailing Address - Fax:321-332-9768
Practice Address - Street 1:1259 W COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-3108
Practice Address - Country:US
Practice Address - Phone:407-203-9492
Practice Address - Fax:321-332-9768
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILESTONES CHILDREN'S THERAPY CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center