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General NPI Number Information
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NPI Number | 1699648014
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Entity Type | Individual
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Provider Name | CARLIE MARIE MCBRAYER PT
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Gender | Female
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 3901 UNIVERSITY BLVD S
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4312
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Country | US
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Telephone | 904-345-7310
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Fax |
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Provider Business Mailing Address
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Address Line | 52 TUSCAN WAY # 202-329
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32092-1850
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Country | US
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Telephone |
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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 | PT42810
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License Number State | FL
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