1720676638 NPI number — LITTLE EXPLORERS THERAPY SERVICES, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720676638 NPI number — LITTLE EXPLORERS THERAPY SERVICES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LITTLE EXPLORERS THERAPY SERVICES, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720676638
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11470 NW 45TH PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUNRISE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33323-1017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-910-7029
Provider Business Mailing Address Fax Number:
786-513-3890

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4517 N PINE ISLAND RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUNRISE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33351-5321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-591-8489
Provider Business Practice Location Address Fax Number:
786-513-3890
Provider Enumeration Date:
01/06/2021

Additional Information

Authorized Official

Authorized Official Last Name:
AMADOR
Authorized Official First Name:
CHANTELLY
Authorized Official Middle Name:
ALEXANDRA
Authorized Official Title or Position:
SPEECH LANGUAGE PATHOLOGIST
Authorized Official Telephone Number:
305-910-7029

Provider Taxonomy Codes

  • Taxonomy code: 261QH0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 115524900 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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