Individual
MAX BURRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1007 PARK DR, CASSELBERRY, FL 32707-3501
(407) 692-6553
Mailing address
1007 PARK DR, CASSELBERRY, FL 32707-3501
(407) 692-6553
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA32152
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA32152
FLORIDA STATE BOARD OF PHYSICAL THERAPY
FL
Enumeration date
01/25/2023
Last updated
01/25/2023
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