Provider Demographics
NPI:1497884399
Name:FIRST STEP THERAPEUTICS
Entity Type:Organization
Organization Name:FIRST STEP THERAPEUTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NOHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-252-7837
Mailing Address - Street 1:1104 BEVILLE ROAD
Mailing Address - Street 2:SUITE J
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-5765
Mailing Address - Country:US
Mailing Address - Phone:386-252-7837
Mailing Address - Fax:386-252-0021
Practice Address - Street 1:1104 BEVILLE ROAD
Practice Address - Street 2:SUITE J
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-5765
Practice Address - Country:US
Practice Address - Phone:386-252-7837
Practice Address - Fax:386-252-0021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM113012081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation MedicineGroup - Single Specialty