Provider Demographics
NPI:1215124409
Name:COMPETITIVE EDGE PERFORMANCE INC
Entity type:Organization
Organization Name:COMPETITIVE EDGE PERFORMANCE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BROOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-849-0150
Mailing Address - Street 1:13046 RACE TRACK RD STE 256
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-1302
Mailing Address - Country:US
Mailing Address - Phone:813-849-0150
Mailing Address - Fax:813-849-0151
Practice Address - Street 1:13817 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-9655
Practice Address - Country:US
Practice Address - Phone:813-849-0150
Practice Address - Fax:813-849-0151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14087261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy