Active NPI
Brandon M Lum, MSPT
- Physical Therapist
- Naples, FL
National Provider Identifier
1255458014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 22730
- Practice address
- 4625 Saint Croix LN Apt 1134
Apt. 1134
Naples, FL 34109-3536 - Phone
- (617) 780-6953
- NPI assigned
- Mar 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 22730 | FL | Primary |
Addresses
Primary practice location
4625 Saint Croix LN Apt 1134
Apt. 1134
Naples, FL 34109-3536
Mailing address
2550 SE Petit LN
Port Saint Lucie, FL 34952-5424
Phone (772) 335-5828
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22730 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osler Medical Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Melbourne, FL
- NPI 1356308670
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255458014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2550 SE PETIT LN",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349525424",
"telephone_number": "772-335-5828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4625 SAINT CROIX LN APT 1134",
"address_2": "APT. 1134",
"city": "NAPLES",
"state": "FL",
"postal_code": "341093536",
"telephone_number": "617-780-6953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUM",
"first_name": "BRANDON",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "MSPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "22730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.