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General NPI Number Information
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NPI Number | 1063501484
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Entity Type | Organization
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Legal Business Name | FITHAB LLC
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 4615 GULF BLVD STE 116
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City | ST PETE BEACH
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State | FL
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Zip | 33706-2454
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Country | US
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Telephone | 727-367-0075
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Fax | 727-367-0402
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Provider Business Mailing Address
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Address Line | PO BOX 468
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City | ST PETERSBURG
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State | FL
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Zip | 33731-0468
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Country | US
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Telephone | 727-367-0075
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAROL H HOLLENBECK
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Credential | P.T.
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Telephone | 727-365-6515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | EXEMPTION# HCC1162
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License Number State | FL
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