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Organization
PRESCRIBED PEDIATRIC EXTENDED CARE, INC
Active
Organization
PRESCRIBED PEDIATRIC EXTENDED CARE, INC
Active
Other names
Pediatric Health Choice
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH FRAZE (EXECUTIVE VP)
(813) 870-0000
Entity
Organization
Contact information
Practice address
8509 BENJAMIN RD, SUITE D, TAMPA, FL 33634-1224
(813) 880-0320
Mailing address
8509 BENJAMIN RD, SUITE D, TAMPA, FL 33634-1224
(813) 880-0320
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
227800000X
Certified Respiratory Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300256001
—
FL
05
—
880567900
—
FL
05
—
880567901
—
FL
05
—
880567902
—
FL
05
—
880567903
—
FL
05
—
880567904
—
FL
05
—
880567905
—
FL
05
—
880567906
—
FL
05
—
880567907
—
FL
05
—
880567908
—
FL
05
—
882377400
—
FL
Enumeration date
11/18/2014
Last updated
04/28/2021
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