Provider Demographics
NPI:1285957902
Name:BRANUM, CLAUDIA (MS, ATC, LAT)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:BRANUM
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 RACHELLE AVE
Mailing Address - Street 2:APT 1013
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-7969
Mailing Address - Country:US
Mailing Address - Phone:903-253-5693
Mailing Address - Fax:
Practice Address - Street 1:1119 SAXON BLVD
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8470
Practice Address - Country:US
Practice Address - Phone:386-774-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT34032255A2300X
FLAL28472255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer