Healthcare Provider Details

I. General information

NPI: 1528876448
Provider Name (Legal Business Name): MICHIEL VREMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2024
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6406 21ST AVE W
BRADENTON FL
34209-7850
US

IV. Provider business mailing address

9506 25TH ST E
PARRISH FL
34219-9196
US

V. Phone/Fax

Practice location:
  • Phone: 941-210-6153
  • Fax:
Mailing address:
  • Phone: 941-565-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT20897
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: