Provider Demographics
NPI:1184852493
Name:AK THERAPY INC
Entity Type:Organization
Organization Name:AK THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTOLSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, OTR/L
Authorized Official - Phone:727-637-6137
Mailing Address - Street 1:2900 W. AZEELE STREET UNIT E
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609
Mailing Address - Country:US
Mailing Address - Phone:727-637-6137
Mailing Address - Fax:727-388-9640
Practice Address - Street 1:2900 W. AZEELE STREET UNIT E
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609
Practice Address - Country:US
Practice Address - Phone:727-637-6137
Practice Address - Fax:727-388-9640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-25
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01373846OtherAMERIGROUP
FL294-719OtherCOVENTRY
9437602OtherAETNA PIN
FL004026100Medicaid
FL357-364OtherWELLCARE
FL4965925OtherCIGNA