Organization
THERAKIDS PLUS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY KATHLENE BOOTH MS CCC-SLP (OWNER)
(813) 873-1936
Entity
Organization
Contact information
Practice address
16102 N FLORIDA AVE, LUTZ, FL 33549-6129
(813) 873-1936
(813) 873-8837
Mailing address
16102 N FLORIDA AVE, LUTZ, FL 33549-6129
(813) 873-1936
(813) 873-8837
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
SA0003850
FL
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
SA3850
FL
261Q00000X
Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
884434800
—
FL
Enumeration date
09/25/2006
Last updated
10/03/2022
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