Brenton Latta, - Physical Therapist in Palm Coast, FL

Brenton Latta, is a Physical Therapist based in Palm Coast, Florida. Brenton Latta is licensed to practice in Illinois (license number 070022132) and his current practice location is 31 Avalon Dr, Palm Coast, Florida. He can be reached at his office (for appointments etc.) via phone at (386) 793-1957.

NPI number for Brenton Latta is 1083081731 and his current mailing address is 31 Avalon Dr, Palm Coast, Florida. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1083081731.

Contact Information

Brenton Latta,
31 Avalon Dr,
Palm Coast, FL 32137-2520
(386) 793-1957
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameBrenton Latta
GenderMale
SpecialityPhysical Therapist
Location31 Avalon Dr, Palm Coast, Florida
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1083081731
  • Provider Enumeration Date: 08/28/2015
  • Last Update Date: 11/15/2016

Medical Identifiers

Medical identifiers for Brenton Latta such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1083081731NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist PT 30630 (Florida)Secondary
225100000XPhysical Therapist 070022132 (Illinois)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brenton Latta is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Brenton Latta,
31 Avalon Dr,
Palm Coast, FL 32137-2520

Ph: () -
Brenton Latta,
31 Avalon Dr,
Palm Coast, FL 32137-2520

Ph: (386) 793-1957

Reviews and Comments


Physical Therapist in Palm Coast, FL

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Phone: 389-445-5555    Fax: 386-445-9800
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Medicare: Medicare Enrolled
Practice Location: 5860 E State Highway 100 Unit 100, Palm Coast, FL 32164
Phone: 386-597-1903    

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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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