Provider Demographics
NPI:1962198200
Name:KJ THERAPY SERVICES LLC
Entity type:Organization
Organization Name:KJ THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:YAHILY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREU SIBERIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-521-4183
Mailing Address - Street 1:12255 SW 39TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3013
Mailing Address - Country:US
Mailing Address - Phone:786-521-4183
Mailing Address - Fax:
Practice Address - Street 1:12255 SW 39TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3013
Practice Address - Country:US
Practice Address - Phone:786-521-4183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty