Provider Demographics
NPI:1235885112
Name:BROWN, JENNIFER JOYCE (DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JOYCE
Last Name:BROWN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8803 CYPRESS MANOR DR APT 108
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3825
Mailing Address - Country:US
Mailing Address - Phone:352-620-5218
Mailing Address - Fax:
Practice Address - Street 1:2600 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-9207
Practice Address - Country:US
Practice Address - Phone:813-929-5407
Practice Address - Fax:813-929-5293
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist