MEDICARE: BREVEN P DALSEMER PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT021233	OH
2	2251P0200X	Pediatric Physical Therapist	PT021233	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235973082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREVEN P DALSEMER PT, DPT

Provider Business Mailing Address
First Line	:	454 RINEHART RD STE 1001
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5251
Country	:	US
Telephone Number	:	407-338-3161
Fax Number	:	407-206-4591

Provider Business Practice Location Address
First Line	:	454 RINEHART RD STE 1001
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5251
Country	:	US
Telephone Number	:	407-338-3161
Fax Number	:	407-206-4591

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2024
Last Update Date	:	01/23/2026

Similar Medicare Providers

1598623621 — JASON BIZJACK DPT
Practice Location Address:

454 RINEHART RD STE 1001
LAKE MARY, FL
32746-5251

Practice Phone: 407-206-4590
Practice Fax:

1578323721 — LITA M MADLANG OT
Practice Location Address:

454 RINEHART RD STE 1001
LAKE MARY, FL
32746-5251

Practice Phone: 407-338-3161
Practice Fax: 407-206-4591

1902071103 — DR. GAAFAR MOHAMMED GAAFAR AHMED D.D.S
Practice Location Address:

12351 DILLINGHAM SQ
LAKE RIDGE, VA
22192-5251

Practice Phone: 703-580-8288
Practice Fax: 703-590-2382

1619113826 — JENNIFER CROSS
Practice Location Address:

5251 LONG LAKE CIR , 203
LAKELAND, FL
33805-9609

Practice Phone: 813-371-3417
Practice Fax:

1972111573 — NINA FARAH
Practice Location Address:

8855 HYPOLUXO RD STE C11
LAKE WORTH, FL
33467-5251

Practice Phone: 561-275-2525
Practice Fax:

1063651131 — DR. NATHAN CHRISTOPHER DEANGELIS D.O.
Practice Location Address:

4106 W LAKE MARY BLVD STE 100
LAKE MARY, FL
32746-3344

Practice Phone: 407-562-5930
Practice Fax: 407-562-5931

Directions to “ BREVEN P DALSEMER PT, DPT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.