Provider Demographics
NPI:1346217593
Name:FIRST STEPS PEDIATRICS PA
Entity Type:Organization
Organization Name:FIRST STEPS PEDIATRICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:GRIER-HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-478-1244
Mailing Address - Street 1:5868 CREEK STATION DR
Mailing Address - Street 2:BUILDING A
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504
Mailing Address - Country:US
Mailing Address - Phone:850-478-1244
Mailing Address - Fax:850-478-1894
Practice Address - Street 1:5868 CREEK STATION DR.
Practice Address - Street 2:BUILDING A
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504
Practice Address - Country:US
Practice Address - Phone:850-478-1244
Practice Address - Fax:850-478-1894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0077102208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268624400Medicaid
FL268624400Medicaid