Provider Demographics
NPI:1346899713
Name:O'DEA, BRITTANY LYNN (PT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LYNN
Last Name:O'DEA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-2613
Mailing Address - Country:US
Mailing Address - Phone:941-485-1505
Mailing Address - Fax:941-485-7495
Practice Address - Street 1:3030 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-2613
Practice Address - Country:US
Practice Address - Phone:941-485-1505
Practice Address - Fax:941-485-7495
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24470225100000X
FLPT41072225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist