Organization
KIDSPACE THERAPY CENTER, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAUL SOTO III (OWNER)
(305) 527-4961
Entity
Organization
Contact information
Practice address
15291 NW 60TH AVE STE 101, MIAMI LAKES, FL 33014-2459
(305) 527-4961
Mailing address
15291 NW 60TH AVE STE 101, MIAMI LAKES, FL 33014-2459
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/01/2020
Last updated
11/08/2023
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