Healthcare Provider Details

I. General information

NPI: 1518842608
Provider Name (Legal Business Name): DETERMINATION FITNESS 365 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 LINWOOD AVE
NAPLES FL
34112-3835
US

IV. Provider business mailing address

3101 LINWOOD AVE
NAPLES FL
34112-3835
US

V. Phone/Fax

Practice location:
  • Phone: 239-227-1803
  • Fax:
Mailing address:
  • Phone: 239-227-1803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MARCI CHARLAND
Title or Position: CREDNTIALING MGR
Credential:
Phone: 231-638-1853