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General NPI Number Information
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NPI Number | 1992357685
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Entity Type | Organization
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Legal Business Name | FIRST STEP PHYSICIANS GROUP, INC
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Dates
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Enumeration Date | 07/12/2019
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 150 SW 12TH AVE STE 480
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3276
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Country | US
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Telephone | 954-482-4333
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Fax |
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Provider Business Mailing Address
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Address Line | 6278 N FEDERAL HWY
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-1916
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AUGUSTINE CROCCO
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Credential |
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Telephone | 954-482-4333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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