NPI 1114744067
Brandon Sports and Aquatics Center, INC.
Practice location
- Address
- 405 Beverly Blvd, Brandon, FL 33511-5507
- Phone
- (813) 689-0908
Authorised official
- Name
- Charles W. Burgess
- Title
- Ceo
- Phone
- (813) 689-0908
Registered specialties
Day Training/Habilitation Specialist
Primary
Registry record
- NPI
- 1114744067
- Entity type
- Organization
- NPI issued
- 23 Sep 2024
- Record last updated
- 7 Jan 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.