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NPI Code Detail

MEDICARE: CARRIE BRENDEL

MEDICARE: CARRIE BRENDEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1437551736
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE BRENDEL
Provider Business Mailing Address
First Line : 12413 WHITE BLUFF RD
Second Line :
City : HUDSON
State : FL
Zip : 34669-5016
Country : US
Telephone Number : 727-741-3405
Fax Number : 727-213-6246
Provider Business Practice Location Address
First Line : 12413 WHITE BLUFF RD
Second Line :
City : HUDSON
State : FL
Zip : 34669-5016
Country : US
Telephone Number : 727-741-3405
Fax Number : 727-213-6246
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2014
Last Update Date : 09/18/2014

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Directions to “ CARRIE BRENDEL ” Practice Location

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