Organization
KIDS QUALITY THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSIELYNN AVILA DPT (DIRECTOR/OWNER)
(305) 985-6122
Entity
Organization
Contact information
Practice address
1550 W 84TH ST, SUITE 58, HIALEAH, FL 33014-3377
(305) 985-6122
(786) 545-7657
Mailing address
1550 W 84TH ST, SUITE 58, HIALEAH, FL 33014-3377
(305) 985-6122
(786) 545-7657
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT26138
FL
225200000X
Physical Therapy Assistant
PTA24257
FL
225XP0200X
Pediatric Occupational Therapist
OT13788
FL
235Z00000X
Speech-Language Pathologist
SA12054
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005450500
—
FL
Enumeration date
05/11/2012
Last updated
03/21/2016
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