Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brandon Clark

Individual provider Physical Therapy Assistant · NPI 1053285353

Brandon Clark is a Physical Therapy Assistant in Lakeland, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2025

Practice location Address checks out

4725 US Highway 98 S Ste 101-102
Lakeland, FL 33812-4334
Phone: (863) 274-9700
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA34319 (FL)

Record details

NPI number1053285353
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 1, 2025
Last updated in NPPESOctober 1, 2025
Certification dateOctober 1, 2025
Mailing address5901 E Fowler Ave Ste 100, Temple Terrace, FL 33617-2305

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