Provider Demographics
NPI:1548377955
Name:BRESLIN, DONNA
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:BRESLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 ENGLISH GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5525
Mailing Address - Country:US
Mailing Address - Phone:407-654-1240
Mailing Address - Fax:
Practice Address - Street 1:6000 TURKEY LAKE RD STE 203
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4206
Practice Address - Country:US
Practice Address - Phone:407-352-3508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4870OtherLICENSE #