Individual
BREVEN P DALSEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
454 RINEHART RD STE 1001, LAKE MARY, FL 32746-5251
(407) 338-3161
(407) 206-4591
Mailing address
454 RINEHART RD STE 1001, LAKE MARY, FL 32746-5251
(407) 338-3161
(407) 206-4591
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT021233
OH
2251P0200X
Pediatric Physical Therapist
PT021233
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0062886
—
OH
Enumeration date
06/25/2024
Last updated
01/23/2026
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