Organization
FLORIDA KIDS THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA BETH OTTO MS, CCC-SLP (DIRECTOR)
(904) 652-5408
Entity
Organization
Contact information
Practice address
11512 LAKE MEAD AVE UNIT 604, JACKSONVILLE, FL 32256-9686
(904) 652-5408
(877) 652-5052
Mailing address
11512 LAKE MEAD AVE UNIT 604, JACKSONVILLE, FL 32256-9686
(904) 652-5408
(877) 652-5052
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/26/2018
Last updated
01/26/2018
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