Provider Demographics
NPI:1659684371
Name:CRANIAL KIDS ORTHOSIS, INC
Entity type:Organization
Organization Name:CRANIAL KIDS ORTHOSIS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARI-YURI
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMARGO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:305-431-8458
Mailing Address - Street 1:14629 SW 104TH ST
Mailing Address - Street 2:SUITE 237
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2905
Mailing Address - Country:US
Mailing Address - Phone:954-983-1899
Mailing Address - Fax:954-986-6846
Practice Address - Street 1:100 SE 15TH AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-3908
Practice Address - Country:US
Practice Address - Phone:954-983-1899
Practice Address - Fax:954-986-6846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 2425332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment