=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346057221
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BREEZE PELVIC HEALTH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/14/2024
-----------------------------------------------------
Last Update Date | 10/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 697 BALBOA ST
-----------------------------------------------------
City | SEBASTIAN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32958-4503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-763-5190
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 697 BALBOA ST
-----------------------------------------------------
City | SEBASTIAN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32958-4503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-763-5190
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PHYSICAL THERAPIST
-----------------------------------------------------
Name | ASHLEY N MURRAY
-----------------------------------------------------
Credential | PT
-----------------------------------------------------
Telephone | 813-763-5190
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------