Bryant Brueckner
Physical Therapist in Port Orange, FL. Individual provider (NPI-1).
NPI number1154854495
StatusActive
Last updated in NPPESApr 4, 2017
Details
- NPI
- 1154854495
- Entity type
- Individual (NPI-1)
- Name
- Bryant Brueckner
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 4, 2017
- Last updated
- Apr 4, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 62170 | OR | Yes |
Practice location
5535 S Williamson BlvdSuite 774
Port Orange, FL 32128-8311
Phone 888-265-2680
Mailing address
5535 S Williamson BlvdSuite 774
Port Orange, FL 32128-8311
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 168 Physical Therapist providers in Port Orange · All 1,907 providers in Port Orange
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