Provider Demographics
NPI:1548831993
Name:SUMMERS, BRETT ROBERT (DL)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:ROBERT
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:DL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10475 GANDY BLVD NORTH
Mailing Address - Street 2:UNIT 1309
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702
Mailing Address - Country:US
Mailing Address - Phone:601-955-4198
Mailing Address - Fax:
Practice Address - Street 1:82 MAXCY PLAZA CIR
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-2488
Practice Address - Country:US
Practice Address - Phone:863-421-9700
Practice Address - Fax:863-421-1953
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12951111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor