Individual ProviderBrenda Charlene KellyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address3599 University Blvd S, Jacksonville, Jacksonville, FL 32216-4252(904) 858-7600PECOS EnrollmentBased on the most recent information from CMS, provider Brenda Charlene Kelly does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1255526497Provider TypeIndividualFull NameKelly, Brenda CharleneTitleMs.CredentialP.T.GenderFemaleSole ProprietorNoEnumeration Date9/11/2007Last Updated9/11/2007Contact InformationPractice LocationPractice Address3599 University Blvd S, Jacksonville, Jacksonville, FL 32216-4252Phone(904) 858-7600Fax(904) 399-6690Mailing LocationMailing Address3599 University Blvd S, Jacksonville, Jacksonville, FL 32216-4252Phone(904) 858-7600Fax(904) 399-6690Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT0001225Florida