MEDICARE: THRIVE & RISE THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1619808847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE & RISE THERAPY LLC

Provider Business Mailing Address
First Line	:	13172 GREEN VIOLET DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-7214
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13172 GREEN VIOLET DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-7214
Country	:	US
Telephone Number	:	813-453-6467
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	AMANDA C GOMEZ
Credential	:	MSOT, OTR/L
Telephone Number	:	813-453-6467

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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Directions to “THRIVE & RISE THERAPY LLC ” Practice Location

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