Organization Active NPI

Brave Kidz LLC

  • Pediatric Skilled Nursing Facility
  • Tampa, FL
National Provider Identifier
1114795309
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X
Legal business name
BRAVE KIDZ LLC
Practice address
20310 Trout Creek Dr
Tampa, FL 33647-3728
Phone
(813) 708-7919
NPI assigned
Dec 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robert Thompson
Title
Managing Partner
Phone
(619) 602-4356

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Skilled Nursing Facility 3140N1450X Primary

Addresses

Primary practice location

20310 Trout Creek Dr
Tampa, FL 33647-3728

Mailing address

20310 Trout Creek Dr
Tampa, FL 33647-3728
Phone (813) 708-7919

National Provider Directory

National Provider Directory

Locations

20310 Trout Creek Dr
Tampa, FL 33647
Phone (813) 708-2919

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1114795309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20310 TROUT CREEK DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473728",
            "telephone_number": "813-708-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20310 TROUT CREEK DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473728",
            "telephone_number": "813-708-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVE KIDZ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-17",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "619-602-4356"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.