Healthcare Provider Details

I. General information

NPI: 1073230173
Provider Name (Legal Business Name): JUMPING STEP BY STEP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2022
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8415 SW 24TH ST STE 205
MIAMI FL
33155-2305
US

IV. Provider business mailing address

8415 SW 24TH ST STE 205
MIAMI FL
33155-2305
US

V. Phone/Fax

Practice location:
  • Phone: 305-262-6868
  • Fax: 305-262-6867
Mailing address:
  • Phone: 305-262-6868
  • Fax: 305-262-6867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA GONZALEZ MCCUBBIN
Title or Position: OWNER
Credential:
Phone: 305-262-6868