Healthcare Provider Details

I. General information

NPI: 1407713050
Provider Name (Legal Business Name): STEP UP CHILDREN'S THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14393 BRIDGEWATER CROSSINGS BLVD STE 130
WINDERMERE FL
34786-3259
US

IV. Provider business mailing address

14393 BRIDGEWATER CROSSINGS BLVD STE 130
WINDERMERE FL
34786-3259
US

V. Phone/Fax

Practice location:
  • Phone: 407-784-6939
  • Fax:
Mailing address:
  • Phone: 407-784-6939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. FABIANA C REIS
Title or Position: CEO
Credential:
Phone: 516-784-7255