Provider Demographics
NPI:1356566285
Name:STEP RIGHT UP CLINIC INC
Entity type:Organization
Organization Name:STEP RIGHT UP CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:J
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:786-276-3668
Mailing Address - Street 1:524 ARTHUR GODFREY RD STE 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3528
Mailing Address - Country:US
Mailing Address - Phone:786-276-3668
Mailing Address - Fax:305-535-1004
Practice Address - Street 1:524 ARTHUR GODFREY RD STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3528
Practice Address - Country:US
Practice Address - Phone:786-276-3668
Practice Address - Fax:305-535-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65785OtherBCBS PIN