Healthcare Provider Details

I. General information

NPI: 1740229160
Provider Name (Legal Business Name): ANDREW NELSON BRICE PT/ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 SW 5TH TER
WILLISTON FL
32696-2548
US

IV. Provider business mailing address

2230 SE 114TH AVE
MORRISTON FL
32668-2147
US

V. Phone/Fax

Practice location:
  • Phone: 353-528-0022
  • Fax: 352-528-2878
Mailing address:
  • Phone: 352-486-5758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT 8094
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT 8094
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAL 484
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: