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Organization
ADVANCED CHILDRENS THERAPY INC
Active
Organization
ADVANCED CHILDRENS THERAPY INC
Active
Other names
ADVANCED CHILDRENS THERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
MARLYE GONZALEZ ALFONSO (ADMINISTRATOR)
(561) 260-1316
Entity
Organization
Contact information
Practice address
2119 10TH AVE N, LAKE WORTH BEACH, FL 33461-3345
(561) 629-6882
(561) 828-3102
Mailing address
2119 10TH AVE N, LAKE WORTH BEACH, FL 33461-3345
(561) 629-6882
(561) 828-3102
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
252Y00000X
Early Intervention Provider Agency
—
NULL
261Q00000X
Clinic/Center
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/21/2019
Last updated
02/26/2023
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