Provider Demographics
NPI:1518449016
Name:GIAMMALVO, BRITTANY (PT, DPT, CLT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:GIAMMALVO
Suffix:
Gender:F
Credentials:PT, DPT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 CONTRAVEST LN
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-6342
Mailing Address - Country:US
Mailing Address - Phone:954-815-2935
Mailing Address - Fax:
Practice Address - Street 1:830 29TH ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-6219
Practice Address - Country:US
Practice Address - Phone:954-815-2935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist