Gail N Brandt, PTA

Individual provider Active NPI Physical Therapy Assistant · Mims, FL

NPI 1366713810 · NPPES record last updated Jan 14, 2012

Key facts

NPI
1366713810
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA2150 (FL)
Practice address
3890 Hammock Rd
Mims, FL 32754-5586
Phone
(321) 269-8027
NPI assigned
Jan 14, 2012
Sex
Female
Sole proprietor
No

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
PTA2150FLMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA2150 FL Yes

Addresses

Primary practice location

3890 Hammock Rd
Mims, FL 32754-5586

Mailing address

3890 Hammock Rd
Mims, FL 32754-5586
Phone (321) 269-8027

Other providers in Mims, FL

All providers in Mims, FL · Physical Therapy Assistant in Florida

Sources for this page

Verify at the official NPI Registry.