Dazzling Kids Therapy, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

DAZZLING KIDS THERAPY, LLC

Practice address

8470 SW 8TH St
Miami, FL 33144

Phone

(305) 603-8105

Fax

(305) 703-4951

NPI assigned

Oct 4, 2017

Organization subpart

No

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

Authorized official

Name

Mayloren Mendez

Title

Owner

Phone

(305) 603-8105

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1780194738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8470 SW 8TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33144",
            "telephone_number": "305-603-8105",
            "fax_number": "305-703-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8470 SW 8TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33144",
            "telephone_number": "305-603-8105",
            "fax_number": "305-703-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAZZLING KIDS THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-04",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "MAYLOREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-603-8105"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022555200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.