| NPI | 1053641001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA MIRANDA RODRIGUEZ Administrator 407-913-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics |
| 225XP0200X Occupational Therapist Pediatrics (Licence: FL OT13570) | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2025-09-02 |