Provider Demographics
NPI:1336288307
Name:WINDSOR, BRIAN ELIOTT (MPT)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:ELIOTT
Last Name:WINDSOR
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11336 CAMPFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-3906
Mailing Address - Country:US
Mailing Address - Phone:904-519-6964
Mailing Address - Fax:
Practice Address - Street 1:11160 BEACH BLVD
Practice Address - Street 2:SUITE 133
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-4875
Practice Address - Country:US
Practice Address - Phone:904-646-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 23175225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist