Healthcare Provider Details

I. General information

NPI: 1306287255
Provider Name (Legal Business Name): BRITTANY GREENBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRITTANY GONICK

II. Dates (important events)

Enumeration Date: 07/08/2013
Last Update Date: 08/24/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8941 SANDY CREST LN
BOYNTON BEACH FL
33473-7813
US

IV. Provider business mailing address

8941 SANDY CREST LN
BOYNTON BEACH FL
33473-7813
US

V. Phone/Fax

Practice location:
  • Phone: 954-263-8493
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: