Functionally Limitless, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT26481 Issued in FL

Legal business name

FUNCTIONALLY LIMITLESS, LLC

Practice address

2425 N Courtenay Pkwy Ste 103
Merritt Island, FL 32953-4181

Phone

(321) 795-4213

Fax

(844) 210-9901

NPI assigned

Jun 5, 2018

Organization subpart

Yes

Parent organization

FUNCTIONALLY LIMITLESS, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Travis D Boersma, DPTNPI 1790068021

Title

Owner

Phone

(954) 325-9395

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Limitless Concierge Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Part of

Functionally Limitless LLC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Travis Daniel Boersma, DPT

  • Physical Therapist
  • Merritt Island, FL
  • NPI 1790068021
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1689166571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 LYNWOOD PL",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534163",
            "telephone_number": "954-325-9395",
            "fax_number": "844-210-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 N COURTENAY PKWY STE 103",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534181",
            "telephone_number": "321-795-4213",
            "fax_number": "844-210-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONALLY LIMITLESS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FUNCTIONALLY LIMITLESS, LLC",
        "enumeration_date": "2018-06-05",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "BOERSMA",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-325-9395",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "726167",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Limitless Concierge Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roderick Anthony Foster, LMT
• Frank X Venzara Mdpa
• Frederick H. Waggener DDS PA
• Doreen Elizabeth Freeman, RDH BS
• Carol Stephanie Frisby, LPN
• Traci Lynn Futch-West, ARNP
• G Leonard Gioia MD PA
• Jessica Marie Gabrius, LPN
• Theresa Gagliardo, APRN
• Mark Anthony George Gagnon Jr., LCSW

• Physical Therapist in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.