Organization
IMAGINATION PEDIATRICS THERAPY CENTER L.L.L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA SHELLEY CHACON (GENERAL PARTNER)
(786) 873-4395
Entity
Organization
Contact information
Practice address
8896 SW 129TH TER, MIAMI, FL 33176-5945
(786) 873-4395
Mailing address
8896 SW 129TH TER, MIAMI, FL 33176-5945
(786) 873-4395
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM3000X
Medically Fragile Infants and Children Day Care
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
12/30/2024
Last updated
12/30/2024
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