Organization
KIDZ POTENTIAL THERAPY SERVICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELIO MUNOZ (PRESIDENT)
(305) 582-8044
Entity
Organization
Contact information
Practice address
2110 SW 21ST ST, MIAMI, FL 33145-2610
(305) 582-8044
Mailing address
2110 SW 21ST ST, MIAMI, FL 33145-2610
(305) 582-8044
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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