Healthcare Provider Details

I. General information

NPI: 1184852493
Provider Name (Legal Business Name): AK THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 01/18/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 W. AZEELE STREET UNIT E
TAMPA FL
33609
US

IV. Provider business mailing address

2900 W. AZEELE STREET UNIT E
TAMPA FL
33609
US

V. Phone/Fax

Practice location:
  • Phone: 727-637-6137
  • Fax: 727-388-9640
Mailing address:
  • Phone: 727-637-6137
  • Fax: 727-388-9640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMANDA KOTOLSKI
Title or Position: OWNER
Credential: PH.D., OTR/L
Phone: 727-637-6137