Healthcare Provider Details

I. General information

NPI: 1356566285
Provider Name (Legal Business Name): STEP RIGHT UP CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 ARTHUR GODFREY RD STE 204
MIAMI BEACH FL
33140-3528
US

IV. Provider business mailing address

524 ARTHUR GODFREY RD STE 204
MIAMI BEACH FL
33140-3528
US

V. Phone/Fax

Practice location:
  • Phone: 786-276-3668
  • Fax: 305-535-1004
Mailing address:
  • Phone: 786-276-3668
  • Fax: 305-535-1004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JACK J COHEN
Title or Position: PRES
Credential: DPM
Phone: 786-276-3668