Individual
ANDREW JAMES BRUNNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1807 SHORT BRANCH DR STE 103, TRINITY, FL 34655-4424
(727) 372-5500
Mailing address
1807 SHORT BRANCH DR STE 103, TRINITY, FL 34655-4424
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT33979
FL
225100000X
Physical Therapist
PTT33979
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B656010934160
—
FL
Enumeration date
09/29/2018
Last updated
02/08/2019
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