Provider Demographics
NPI:1720262256
Name:BRESLIN, LANA K (PT)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:K
Last Name:BRESLIN
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 1:12793 MEADOWBREEZE DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-8057
Mailing Address - Country:US
Mailing Address - Phone:561-795-7795
Mailing Address - Fax:
Practice Address - Street 1:12793 MEADOWBREEZE DR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-8057
Practice Address - Country:US
Practice Address - Phone:561-795-7795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2016-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT00048152251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic