Healthcare Provider Details

I. General information

NPI: 1669585287
Provider Name (Legal Business Name): MELISSA SUSAN BRODSKY PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 GREENWOOD AVE STE 101
MANGONIA PARK FL
33407-2452
US

IV. Provider business mailing address

3375 BURNS RD STE 104
PALM BEACH GARDENS FL
33410-4360
US

V. Phone/Fax

Practice location:
  • Phone: 561-844-5255
  • Fax:
Mailing address:
  • Phone: 561-352-4029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT20204
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: