Healthcare Provider Details

I. General information

NPI: 1134665466
Provider Name (Legal Business Name): BRANDON MICHAEL KEILMAN PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2017
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 ORANGE AVE
WINTER PARK FL
32789-4909
US

IV. Provider business mailing address

1341 ORANGE AVE
WINTER PARK FL
32789-4909
US

V. Phone/Fax

Practice location:
  • Phone: 407-691-7687
  • Fax: 407-691-7697
Mailing address:
  • Phone: 407-691-7687
  • Fax: 407-691-7697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number30323
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: