Organization
PROGRESSIVE PEDIATRIC THERAPY SERVICES
Active
Parent organization
PROGRESSIVE PEDIATRIC DEVELOPMENTAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROGRESSIVE PEDIATRIC DEVELOPMENTAL CENTER
Authorized official
MRS. TAMMY MCKENZIE OTR/L (EXECUTIVE DIRECTOR)
(850) 524-2048
Entity
Organization
Contact information
Practice address
2005 SANDCASTLE DR, TALLAHASSEE, FL 32308-4864
(904) 226-8890
Mailing address
2005 SANDCASTLE DR, TALLAHASSEE, FL 32308-4864
(904) 226-8890
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
12786
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY
FL
Enumeration date
03/11/2013
Last updated
05/21/2020
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