Provider Demographics
NPI:1841597630
Name:KEEFE, BRENDA L (PT)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:L
Last Name:KEEFE
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 1:4025 CEDAR ISLAND RD E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-2208
Mailing Address - Country:US
Mailing Address - Phone:678-360-7598
Mailing Address - Fax:
Practice Address - Street 1:4800 FIRST COAST HWY STE 240
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-5598
Practice Address - Country:US
Practice Address - Phone:904-321-5491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2025-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT33274225100000X
GAPT004716225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist