Provider Demographics
NPI:1255156394
Name:PARKER, BRANDON ERIC (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:ERIC
Last Name:PARKER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6954 PIAZZA GRANDE AVE APT 6203
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-8798
Mailing Address - Country:US
Mailing Address - Phone:508-431-4445
Mailing Address - Fax:
Practice Address - Street 1:2441 S HIAWASSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6347
Practice Address - Country:US
Practice Address - Phone:407-965-5818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL42361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist