Kids Miracle Steps, Inc.

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

Legal business name

KIDS MIRACLE STEPS, INC.

Practice address

1371-1381 N Palm Ave.
Pembroke Pines, FL 33024

Phone

(954) 505-4937

Fax

(954) 212-8111

NPI assigned

Jan 13, 2020

Organization subpart

No

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

Authorized official

Name

Galina Klyachman

Title

Administrator

Phone

(646) 662-8658

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1710527296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371-1381 N PALM AVE.",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "954-505-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371-1381 N PALM AVE.",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "954-505-4937",
            "fax_number": "954-212-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS MIRACLE STEPS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-13",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "KLYACHMAN",
        "authorized_official_first_name": "GALINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "646-662-8658"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105261500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Skilled Nursing Facility in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Pediatric Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.