Healthcare Provider Details

I. General information

NPI: 1588088660
Provider Name (Legal Business Name): BREANNA GOLDSTEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2014
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8802 MORGAN LANDING WAY
BOYNTON BEACH FL
33473-7826
US

IV. Provider business mailing address

8802 MORGAN LANDING WAY
BOYNTON BEACH FL
33473-7826
US

V. Phone/Fax

Practice location:
  • Phone: 813-417-7344
  • Fax:
Mailing address:
  • Phone: 813-417-7344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number16109
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: