Provider Demographics
NPI:1255868303
Name:BRANSON, BARRIE OLIVER
Entity Type:Individual
Prefix:
First Name:BARRIE
Middle Name:OLIVER
Last Name:BRANSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 TURNBERRY CT
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2532
Mailing Address - Country:US
Mailing Address - Phone:321-693-8032
Mailing Address - Fax:
Practice Address - Street 1:1295 TURNBERRY CT
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2532
Practice Address - Country:US
Practice Address - Phone:321-693-8032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT3462227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered