Provider Demographics
NPI:1962893917
Name:EMPOWERED PT, PLLC
Entity type:Organization
Organization Name:EMPOWERED PT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:F
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:813-508-2553
Mailing Address - Street 1:2705 W MISSISSIPPI AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-6131
Mailing Address - Country:US
Mailing Address - Phone:813-508-2553
Mailing Address - Fax:352-475-5393
Practice Address - Street 1:2705 W MISSISSIPPI AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-6131
Practice Address - Country:US
Practice Address - Phone:813-508-2553
Practice Address - Fax:352-475-5393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-12
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24895261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy