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General NPI Number Information
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NPI Number | 1750299301
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Entity Type | Individual
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Provider Name | I'KIA BREWTON
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Gender |
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 90 HIDDEN LAKE DR APT 142
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City | SANFORD
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State | FL
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Zip | 32773-5518
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Country | US
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Telephone | 321-947-5382
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Fax |
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Provider Business Mailing Address
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Address Line | 90 HIDDEN LAKE DR APT 142
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City | SANFORD
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State | FL
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Zip | 32773-5518
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Country | US
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Telephone | 321-947-5382
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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 | PTA34897
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License Number State | FL
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