Individual ProviderBrandy Nicole SidesPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4101 Southpoint Dr E, Jacksonville, FL 32216-0996(904) 296-6800PECOS EnrollmentBased on the most recent information from CMS, provider Brandy Nicole Sides 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 2 days ago.Profile DetailsProvider ID1396110417Provider TypeIndividualFull NameSides, Brandy NicoleCredentialPT, DPTGenderFemaleSole ProprietorNoEnumeration Date12/1/2015Last Updated12/1/2015Contact InformationPractice LocationPractice Address4101 Southpoint Dr E, Jacksonville, FL 32216-0996Phone(904) 296-6800FaxUnlisted FaxMailing LocationMailing Address4101 Southpoint Dr E, Jacksonville, FL 32216-0996PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT 31018Florida