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General NPI Number Information
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NPI Number | 1508116419
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Entity Type | Organization
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Legal Business Name | FIRST STEP PODIATRY, LLC
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 7857 W. SAMPLE RD SUITE 157
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4748
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Country | US
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Telephone | 561-350-6699
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Fax | 954-757-7009
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Provider Business Mailing Address
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Address Line | 7857 W. SAMPLE RD SUITE 157
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4748
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Country | US
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Telephone | 561-350-6699
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Fax | 954-757-7009
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Authorized Official
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Title or Position | PRESIENT
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Name | YANICK BEAUVOIR MAYNARD
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Credential | DPM
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Telephone | 561-350-6699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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