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General NPI Number Information
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NPI Number | 1639040785
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Entity Type | Individual
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Provider Name | CONNOR MARTIN BROWN PT,DPT,CSCS
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Gender | Male
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 25 S TERRY AVE
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City | ORLANDO
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State | FL
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Zip | 32805-1843
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Country | US
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Telephone | 407-641-2446
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Fax |
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Provider Business Mailing Address
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Address Line | 2389 FORREST RD
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City | WINTER PARK
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State | FL
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Zip | 32789-6028
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Country | US
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Telephone | 407-712-4956
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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 | PT43494
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License Number State | FL
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