Provider Demographics
NPI:1285002816
Name:TAKE CONTROL PHYSICAL THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:TAKE CONTROL PHYSICAL THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:813-530-0520
Mailing Address - Street 1:13403 BOYETTE RD
Mailing Address - Street 2:TAKE CONTROL PHYSICAL THERAPY
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-8742
Mailing Address - Country:US
Mailing Address - Phone:813-530-0520
Mailing Address - Fax:
Practice Address - Street 1:13403 BOYETTE RD
Practice Address - Street 2:TAKE CONTROL PHYSICAL THERAPY
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-8742
Practice Address - Country:US
Practice Address - Phone:813-530-0520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4206225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty