Individual
BRIANA NICOLE KIDD I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
100 WAYMONT CT, LAKE MARY, FL 32746-3412
(407) 323-0399
Mailing address
605 BANDERAS AVE, OCOEE, FL 34761-2908
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT28478
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT28478
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
12/25/2018
Last updated
12/25/2018
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