Provider Demographics
NPI:1528758158
Name:KINSEY, BRETT (DPT, PT)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:KINSEY
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 N ACCESS RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34224-8655
Mailing Address - Country:US
Mailing Address - Phone:941-460-3831
Mailing Address - Fax:941-218-5627
Practice Address - Street 1:1499 E VENICE AVE UNIT A
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-3207
Practice Address - Country:US
Practice Address - Phone:941-451-8657
Practice Address - Fax:941-218-5627
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTT40131225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty