Provider Demographics
NPI: | 1831420033 |
---|---|
Name: | FIRST STEP THERAPY, LLC |
Entity type: | Organization |
Organization Name: | FIRST STEP THERAPY, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | COO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | FEDERICO |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NICHOLAS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 407-530-5063 |
Mailing Address - Street 1: | 1650 SAND LAKE RD STE 230 |
Mailing Address - Street 2: | |
Mailing Address - City: | ORLANDO |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32809-9138 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 407-530-5063 |
Mailing Address - Fax: | 877-399-5578 |
Practice Address - Street 1: | 1200 N CENTRAL AVE |
Practice Address - Street 2: | |
Practice Address - City: | KISSIMMEE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 34741-4450 |
Practice Address - Country: | US |
Practice Address - Phone: | 407-530-5063 |
Practice Address - Fax: | 877-399-5578 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-01-27 |
Last Update Date: | 2023-07-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
103K00000X, 106E00000X, 106S00000X, 208100000X, 2081P0010X, 225100000X, 225X00000X, 235Z00000X, 251S00000X, 261QM1300X, 261Q00000X | ||
FL | PT22445 | 252Y00000X |
FL | 3747P1801X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
No | 106E00000X | Behavioral Health & Social Service Providers | Assistant Behavior Analyst | Group - Multi-Specialty | |
No | 106S00000X | Behavioral Health & Social Service Providers | Behavior Technician | Group - Multi-Specialty | |
No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
No | 2081P0010X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pediatric Rehabilitation Medicine | Group - Multi-Specialty |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
No | 252Y00000X | Agencies | Early Intervention Provider Agency | Group - Multi-Specialty | |
No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |
No | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant | Group - Multi-Specialty |