Organization
FKPPEC4, INC.
Active
Other names
FIRST KID'S PPEC
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN DAVID CARVAJAL ESQ (CHIEF COMPLIANCE OFFICER)
(305) 796-5103
Entity
Organization
Contact information
Practice address
7202 W COLONIAL DR, ORLANDO, FL 32818-6743
(866) 635-7732
Mailing address
6515 TAFT ST, HOLLYWOOD, FL 33024-4008
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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