Healthcare Provider Details

I. General information

NPI: 1598684664
Provider Name (Legal Business Name): SUCCESSFUL STEPS SUPPORT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12553 NEW BRITTANY BLVD STE 3215
FORT MYERS FL
33907-3625
US

IV. Provider business mailing address

12553 NEW BRITTANY BLVD STE 3215
FORT MYERS FL
33907-3625
US

V. Phone/Fax

Practice location:
  • Phone: 239-823-5062
  • Fax: 239-790-5740
Mailing address:
  • Phone: 239-823-5062
  • Fax: 239-790-5740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA N ROBINSON
Title or Position: AREA DIRECTOR
Credential: ROBINSON
Phone: 239-634-6025