Organization
THE KIDZ CLUB- ST PETE, LLC
Active
Parent organization
KY PPEC, INC
Other names
The Kidz Club- St. Pete
Organization subpart
Yes
Provider details
NPI number
Legal business name
KY PPEC, INC
Authorized official
RICHARD C WHITE (COO)
(502) 210-5538
Entity
Organization
Contact information
Practice address
850 3RD AVE S, ST PETERSBURG, FL 33701-4010
(727) 821-5439
(727) 821-9459
Mailing address
1101 HERR LN, LOUISVILLE, KY 40222-4301
(502) 210-5538
(502) 327-5098
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
002082100
FL
3140N1450X
Pediatric Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003967600
—
FL
Enumeration date
06/21/2011
Last updated
05/19/2015
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