Provider Demographics
NPI:1588351092
Name:FIRST STEP PODIATRY OF SOUTH FLORIDA INC
Entity type:Organization
Organization Name:FIRST STEP PODIATRY OF SOUTH FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YANICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAUVOIR MAYNARD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:754-229-6372
Mailing Address - Street 1:7857 W SAMPLE RD STE 157
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4748
Mailing Address - Country:US
Mailing Address - Phone:754-229-6372
Mailing Address - Fax:954-944-2926
Practice Address - Street 1:7857 W SAMPLE RD STE 157
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4748
Practice Address - Country:US
Practice Address - Phone:754-229-6372
Practice Address - Fax:954-944-2926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty