IndividualActive
Samuel Gough, PTA
NPI 1629317516 · Physical Therapy Assistant · Melbourne, FL
Provider details
- NPI number
- 1629317516
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- Yes
- License
- PTA14486 (FL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3033 Sarno Rd
Melbourne, FL 32934-7229
Phone: (321) 242-6812
Street-level locationGet directions
Mailing address
825 Arthur St Se
Palm Bay, FL 32909-3756
Registry dates
- Enumerated
- 2013-02-12
- Last updated
- 2013-02-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.