| Optimal Performance And Physical Therapies-brandon Llc | |
|
1056 E Brandon Blvd, Brandon, FL 33511-5509 | |
| (813) 690-4414 | |
| Not Available |
| Full Name | Optimal Performance And Physical Therapies-brandon Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 1056 E Brandon Blvd, Brandon, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407132632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT4616 (Florida) | Primary |
| Provider Name | David Caracci |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598936007 PECOS PAC ID: 1456400951 Enrollment ID: I20090512000329 |
| Provider Name | Beth A Patterson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215051776 PECOS PAC ID: 8628103496 Enrollment ID: I20100318000337 |
| Provider Name | Douglas D Buethe |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164528451 PECOS PAC ID: 4880879196 Enrollment ID: I20110502000627 |
| Provider Name | Stephanie M Bridwell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649376690 PECOS PAC ID: 5395920581 Enrollment ID: I20110504000031 |
| Provider Name | Anthony C King |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306274030 PECOS PAC ID: 6608002167 Enrollment ID: I20131112001075 |
| Provider Name | Collin Wallace |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568830719 PECOS PAC ID: 0042591109 Enrollment ID: I20170103001453 |
| Provider Name | Lauren Rivera |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336682905 PECOS PAC ID: 6507149952 Enrollment ID: I20170208001738 |
| Provider Name | David Nolen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275003089 PECOS PAC ID: 2264779867 Enrollment ID: I20190118002785 |
| Provider Name | Hillary Hixon |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1023582764 PECOS PAC ID: 2062759830 Enrollment ID: I20190201000543 |
| Provider Name | Leanne Updike |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710599444 PECOS PAC ID: 1456778059 Enrollment ID: I20200827002049 |
| Provider Name | Brittany Ann Minter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811592041 PECOS PAC ID: 6608288717 Enrollment ID: I20201215000830 |
| Provider Name | Liam Coakley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770176026 PECOS PAC ID: 6800203241 Enrollment ID: I20210331000337 |
| Provider Name | Lesley Samulak |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831862804 PECOS PAC ID: 8123418878 Enrollment ID: I20211213000241 |
| Provider Name | Maria Rey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891448858 PECOS PAC ID: 2769875012 Enrollment ID: I20220209000168 |
| Provider Name | Trent Wynn |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770296626 PECOS PAC ID: 4981061355 Enrollment ID: I20230531002018 |
| Mailing Address | Practice Location Address |
|---|---|
| Optimal Performance And Physical Therapies-brandon Llc 6023 Hammock Woods Dr, Odessa, FL 33556-3330 Ph: () - | Optimal Performance And Physical Therapies-brandon Llc 1056 E Brandon Blvd, Brandon, FL 33511-5509 Ph: (813) 690-4414 |
Mr. Ronney Etienne, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 116 E Bloomingdale Ave, Brandon, FL 33511 Phone: 813-655-3342 Fax: 813-653-0894 | |
Jennifer Bishop, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1056 E Brandon Blvd, Brandon, FL 33511 Phone: 813-413-5513 Fax: 813-681-8300 | |
Tracy A Hennemann, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 116 E Bloomingdale Ave, Brandon, FL 33511 Phone: 891-365-5334 Fax: 813-653-0894 | |
Hillary Hixon, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1076 E Brandon Blvd Ste 106, Brandon, FL 33511 Phone: 813-413-5513 | |
Mr. Randall Walter Grossglass, PT Physical Therapist Medicare: May Accept Medicare Assignments Practice Location: 134 E Bloomingdale Ave, Brandon, FL 33511 Phone: 813-681-1627 Fax: 813-684-1356 | |
Marc Boults, Physical Therapist Medicare: Medicare Enrolled Practice Location: 602 Vonderburg Dr, Suite 201, Brandon, FL 33511 Phone: 863-617-9400 Fax: 863-688-9858 | |
Deborah Raplee, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1056 E Brandon Blvd, Brandon, FL 33511 Phone: 813-413-5513 Fax: 813-681-8300 |