Provider Demographics
NPI:1396412045
Name:FUERZA PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:FUERZA PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GACH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:816-462-8565
Mailing Address - Street 1:401 N ROME AVE APT 4306
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-0050
Mailing Address - Country:US
Mailing Address - Phone:816-462-8565
Mailing Address - Fax:
Practice Address - Street 1:1601 N MARION ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-2638
Practice Address - Country:US
Practice Address - Phone:816-462-8565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-29
Last Update Date:2021-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy