Brenda M Collins, DPT

Individual provider Active NPI Pediatric Physical Therapist · Summerfield, FL

NPI 1083760037 · NPPES record last updated Nov 3, 2020

Key facts

NPI
1083760037
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Physical Therapist 2251P0200X
License
PT30120 (FL)
Practice address
16280 SE 88TH Ave
Summerfield, FL 34491-7037
Phone
(631) 806-1422
Fax
(352) 693-2102
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT30120FLMDPediatric Physical Therapist
012846-1NYMDPediatric Physical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X PT30120 FL
Pediatric Physical Therapist 2251P0200X 012846-1 NY
Pediatric Physical Therapist 2251P0200X PT30120 FL Yes

Addresses

Primary practice location

16280 SE 88TH Ave
Summerfield, FL 34491-7037

Mailing address

16280 SE 88TH Ave
Summerfield, FL 34491-7037
Phone (631) 806-1422

Other providers in Summerfield, FL

All providers in Summerfield, FL · Pediatric Physical Therapist in Florida

Sources for this page

Verify at the official NPI Registry.