Provider Demographics
NPI:1871321679
Name:PASI, BROOKE M (DPT)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:M
Last Name:PASI
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 1:3672 TOUR TRCE
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-4439
Mailing Address - Country:US
Mailing Address - Phone:814-594-6506
Mailing Address - Fax:
Practice Address - Street 1:5130 KELLY RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4726
Practice Address - Country:US
Practice Address - Phone:813-739-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT26734225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist