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General NPI Number Information
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NPI Number | 1073330999
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Entity Type | Organization
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Legal Business Name | TROPIC ATHLETE, LLC
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Dates
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Enumeration Date | 09/23/2024
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 1819 RIVERVIEW DR STE 201
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City | MELBOURNE
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State | FL
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Zip | 32901-4794
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Country | US
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Telephone | 321-294-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 455 BAHAMA DR
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City | INDIALANTIC
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State | FL
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Zip | 32903-4101
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AMBR
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Name | MATTHEW MARTIN
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Credential | DPT
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Telephone | 321-749-1650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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