Healthcare Provider Details

I. General information

NPI: 1659023281
Provider Name (Legal Business Name): ORTHO ATHLETE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4993 TAMIAMI TRL N SUITE 200
NAPLES FL
34103
US

IV. Provider business mailing address

4474 CALDERA CIR
NAPLES FL
34119-9057
US

V. Phone/Fax

Practice location:
  • Phone: 239-360-5665
  • Fax: 949-666-4167
Mailing address:
  • Phone: 802-363-8745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIK HEMMETT
Title or Position: OWNER
Credential: DC
Phone: 802-363-8745