Provider Demographics
NPI:1982779906
Name:EDUCATED PLAY, INC.
Entity Type:Organization
Organization Name:EDUCATED PLAY, INC.
Other - Org Name:THERAPY PLAYHOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURI
Authorized Official - Middle Name:B
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:727-423-0060
Mailing Address - Street 1:8673 15TH WAY N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2815
Mailing Address - Country:US
Mailing Address - Phone:727-423-0060
Mailing Address - Fax:727-369-8803
Practice Address - Street 1:8673 15TH WAY N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-2815
Practice Address - Country:US
Practice Address - Phone:727-423-0060
Practice Address - Fax:727-369-8803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 131302251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890937700Medicaid