Organization
PEDIATRIC THERAPY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRAHAM KILBURN (OWNER/PRESIDENT)
(813) 662-1060
Entity
Organization
Contact information
Practice address
206 RIDGEWOOD AVE, BRANDON, FL 33510
(813) 662-1060
(813) 662-0530
Mailing address
206 RIDGEWOOD AVE, BRANDON, FL 33510-4617
(813) 662-1060
(813) 662-0530
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
PT5990
FL
225XP0200X
Pediatric Occupational Therapist
OT1478
FL
235Z00000X
Speech-Language Pathologist
SA7398
FL
261Q00000X
Clinic/Center
Primary
—
—
332BC3200X
Customized Equipment (DME)
PT2549
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024393800
—
FL
01
—
13424302
CITRUS COMMERCIAL/HMO
FL
01
—
6406221
UNITED HEALTHCARE
FL
01
—
664175
AETNA
FL
05
—
8803579-01
—
FL
05
—
8803579-04
—
FL
01
—
8810363001
CIGNA
FL
01
—
Y906F
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/05/2008
Last updated
08/20/2018
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