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NPI Code Detail

MEDICARE: JAMIE L BREWER LMT,MMP

MEDICARE: JAMIE L BREWER LMT,MMP
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
1225400000XRehabilitation PractitionerMA72705FL

General Provider Information

NPI Number : 1407312622
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE L BREWER LMT,MMP
Provider Business Mailing Address
First Line : 716 S OAKWOOD AVE
Second Line :
City : BRANDON
State : FL
Zip : 33511-6124
Country : US
Telephone Number : 813-833-3840
Fax Number :
Provider Business Practice Location Address
First Line : 716 S OAKWOOD AVE
Second Line :
City : BRANDON
State : FL
Zip : 33511-6124
Country : US
Telephone Number : 813-833-3840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2019
Last Update Date : 02/12/2019

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