Provider Demographics
NPI:1659978948
Name:BERUMEN LOMES, BRAYAN URIEL (DPT)
Entity type:Individual
Prefix:
First Name:BRAYAN
Middle Name:URIEL
Last Name:BERUMEN LOMES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9430 W OREGON AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-3348
Mailing Address - Country:US
Mailing Address - Phone:480-241-1721
Mailing Address - Fax:
Practice Address - Street 1:1951 W CAMELBACK RD STE 101
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-3483
Practice Address - Country:US
Practice Address - Phone:480-396-2781
Practice Address - Fax:480-854-3094
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31466225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist