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Organization
RADIANT PEDIATRIC THERAPY, LLC
Active
Organization
RADIANT PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH ANN PATRICK M.S., CCC-SLP (OWNER)
(786) 200-8222
Entity
Organization
Contact information
Practice address
10901 SW 102ND CT, MIAMI, FL 33176-3472
(786) 200-8222
(786) 913-5062
Mailing address
10901 SW 102ND CT, MIAMI, FL 33176-3472
(786) 200-8222
(786) 913-5062
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004566900
—
FL
Enumeration date
01/22/2019
Last updated
10/03/2019
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