Provider Demographics
NPI:1336179241
Name:PRO NETWORKING PLUS, INC.
Entity Type:Organization
Organization Name:PRO NETWORKING PLUS, INC.
Other - Org Name:MILLENNIUM THERAPEUTIC & PEDIATRIC WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR / L
Authorized Official - Phone:786-293-3933
Mailing Address - Street 1:11845 SW 216 STREET
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-2938
Mailing Address - Country:US
Mailing Address - Phone:786-293-3933
Mailing Address - Fax:305-378-0078
Practice Address - Street 1:11845 SW 216 STREET
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-2938
Practice Address - Country:US
Practice Address - Phone:786-293-3933
Practice Address - Fax:305-378-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 2005225X00000X
225X00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL887107800Medicaid