Healthcare Provider Details

I. General information

NPI: 1871471235
Provider Name (Legal Business Name): FITNESS QUEST - VENICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9025 TOWN CENTER PKWY
LAKEWOOD RANCH FL
34202-4175
US

IV. Provider business mailing address

1650 LYNDON FARM CT STE 300
LOUISVILLE KY
40223-5005
US

V. Phone/Fax

Practice location:
  • Phone: 941-209-3922
  • Fax: 941-209-3912
Mailing address:
  • Phone:
  • Fax: 812-590-8333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA MCCAULEY
Title or Position: CHIEF LEGAL AND COMPLIANCE OFFICER
Credential:
Phone: 502-576-3300