Organization
LILPICASSOS,INC.
Active
Other names
LilPicassos
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOANNE BETANCES (PRESIDENT)
(954) 551-9097
Entity
Organization
Contact information
Practice address
12555 ORANGE DR, SUITE 4022-A, DAVIE, FL 33330-4304
(954) 394-5521
Mailing address
12555 ORANGE DR, SUITE 4022-A, DAVIE, FL 33330-4304
(954) 394-5521
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710122965
DEVELOPMENTAL THERAPIST
FL
Enumeration date
06/20/2012
Last updated
08/01/2012
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