Provider Demographics
NPI:1609965037
Name:ALIS-BROWN, GAYLE PATRICIA (DPT)
Entity type:Individual
Prefix:
First Name:GAYLE
Middle Name:PATRICIA
Last Name:ALIS-BROWN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2761 CITRUS TOWER BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-7010
Mailing Address - Country:US
Mailing Address - Phone:352-227-1757
Mailing Address - Fax:352-227-1758
Practice Address - Street 1:2761 CITRUS TOWER BLVD STE 103
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-7010
Practice Address - Country:US
Practice Address - Phone:352-227-1757
Practice Address - Fax:352-227-1758
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT37322225100000X
CAPT30087225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist