Organization
KOOL KIDS CLUB REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK COLL (PRESIDENT/OCCUPATIONAL THERAPIST)
(786) 412-2538
Entity
Organization
Contact information
Practice address
6934 SW 114TH PL APT H, MIAMI, FL 33173-1876
(786) 412-2538
Mailing address
6934 SW 114TH PL APT H, MIAMI, FL 33173-1876
(786) 412-2538
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT23932
FL
225X00000X
Occupational Therapist
Primary
OT12161
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609048230
INDIVIDUAL NPI
FL
01
—
1871800599
INDIVIDUAL NPI
FL
Enumeration date
10/26/2011
Last updated
10/26/2011
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