Provider Demographics
NPI:1841569779
Name:NEXT STEP THERAPY SERVICES
Entity Type:Organization
Organization Name:NEXT STEP THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARREGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-315-8525
Mailing Address - Street 1:365 SUMMERCOVE CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-5951
Mailing Address - Country:US
Mailing Address - Phone:904-315-8525
Mailing Address - Fax:
Practice Address - Street 1:365 SUMMERCOVE CIR
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5951
Practice Address - Country:US
Practice Address - Phone:904-315-8525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20341222Q00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004473600Medicaid