Larry Wayne Breeden

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA 18170 Issued in FL

Practice address

2 Columbia Dr
Tampa, FL 33606-3508

Phone

(813) 844-7707

NPI assigned

Aug 5, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1508022989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 COLUMBIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COLUMBIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063508",
            "telephone_number": "813-844-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEDEN",
        "first_name": "LARRY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-05",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 18170",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2065620",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breathewell Pulmonary Clinic LLC
• Matthew U. Brecher, D.C.
• Brittany Leigh Brecklin, AGNP
• Laura Bredenberg, PHARMD
• Hailey Breece
• Ajay Zachary Breen, DO
• Richard Alan Breen, RRT
• Shannon Breen
• Katherine Emilie Breese, DO, MPO/CPO
• Breezefast LLC

• Physical Therapy Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.