Provider Demographics
NPI:1033445176
Name:BRUMFIELD, TERI ANN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:TERI
Middle Name:ANN
Last Name:BRUMFIELD
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4161 TAMIAMI TRL STE 704
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-9283
Mailing Address - Country:US
Mailing Address - Phone:941-625-1110
Mailing Address - Fax:941-625-0552
Practice Address - Street 1:2980 WESTBERRY TER
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34286-8750
Practice Address - Country:US
Practice Address - Phone:814-602-1369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-25
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT325142251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic