Organization
THE PEACH PIT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTINE FRADILLADA (MANAGER)
(561) 809-5461
Entity
Organization
Contact information
Practice address
2216 S JOG RD, GREENACRES, FL 33415-6101
(561) 412-5577
Mailing address
9861 ROBINS NEST RD, BOCA RATON, FL 33496-2144
(561) 809-5461
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020460500
—
FL
Enumeration date
03/17/2022
Last updated
06/26/2025
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