Functionally Fit Fitness Center, Inc

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

19703 Issued in FL

Legal business name

FUNCTIONALLY FIT FITNESS CENTER, INC

Doing business as

Functionally Fit Fitness Center, INC

Practice address

3802 Murrell Rd
Rockledge, FL 32955

Phone

(321) 877-2090

NPI assigned

Dec 26, 2017

Last updated

May 29, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gerald Bowman, PTA, DCNPI 1043749799

Title

Owner

Phone

(302) 543-0133

Specialties & licenses 3

Addresses

Other names 2

• Functionally Fit Fitness Center, INC Doing business as
• Functionally Fit Chiropractor Inc Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gerald Bowman, PTA, DC

  • Chiropractor
  • Rockledge, FL
  • NPI 1043749799
  Medicare reassignment NPD Authorized official
• Roger Henderson, PT

  • Physical Therapist
  • Rockledge, FL
  • NPI 1073557070

  Physical Medicine & Rehabilitation

  Medicare reassignment NPD
• Heidi Mattessich, PT

  • Physical Medicine & Rehabilitation Physician
  • Rockledge, FL
  • NPI 1871232736
  NPD

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780012800000",
    "number": "1740796895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 N WICKHAM RD UNIT 12-514",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407976",
            "telephone_number": "302-543-0133",
            "fax_number": "321-349-0217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 MURRELL RD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "32955",
            "telephone_number": "321-877-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONALLY FIT FITNESS CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-26",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-543-0133",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PTA, DC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "19703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Functionally Fit Fitness Center, INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Functionally Fit Chiropractor Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brenda L Friend, SLP
• Garry Fuller, MD
• Ivette Yolanda Fuller
• Kelly Fuller, APRN
• Functionally Fit Chiropractic, Inc.
• Fyzical Therapy & Balance Center Rockledge-Viera (Fyzical Therapy and Balance Center Rockledge-Viera)
• Alana J Gainer, APRN
• Angela Michelle Gallagher, REGISTERED DIETITIAN
• Vickie Sue Gangwish, MSW
• Leylani Garcia

• Physical Medicine & Rehabilitation Physician in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.