Provider Demographics
NPI:1578386421
Name:UPGRADE PHYSICAL THERAPY AND FITNESS, LLC
Entity type:Organization
Organization Name:UPGRADE PHYSICAL THERAPY AND FITNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, PT
Authorized Official - Phone:407-633-9594
Mailing Address - Street 1:15817 OAKLAND CT
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-8142
Mailing Address - Country:US
Mailing Address - Phone:407-633-9594
Mailing Address - Fax:
Practice Address - Street 1:11920 W COLONIAL DR # 30
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3312
Practice Address - Country:US
Practice Address - Phone:407-205-8145
Practice Address - Fax:888-949-1295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty