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General NPI Number Information
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NPI Number | 1215535877
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Entity Type | Individual
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Provider Name | BRYAN K BROZY PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 3716 UNIVERSITY BLVD S STE 4
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4318
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Country | US
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Telephone | 904-733-8133
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Fax |
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Provider Business Mailing Address
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Address Line | 13720 OLD SAINT AUGUSTINE RD STE 8-118
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City | JACKSONVILLE
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State | FL
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Zip | 32258-7414
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Country | US
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Telephone | 336-813-2396
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT35906
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License Number State | FL
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