MEDICARE: 3-STEP THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598344277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	3-STEP THERAPY

Provider Business Mailing Address
First Line	:	5100 W COPANS RD STE 300
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-7700
Country	:	US
Telephone Number	:	954-825-3317
Fax Number	:	954-793-4949

Provider Business Practice Location Address
First Line	:	5100 W COPANS RD STE 300
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-7700
Country	:	US
Telephone Number	:	954-825-3317
Fax Number	:	954-793-4949

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. THEODIS LAMAR FULMORE JR.
Credential	:
Telephone Number	:	954-825-3317

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	12/12/2022

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Directions to “3-STEP THERAPY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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