Healthcare Provider Details

I. General information

NPI: 1376228817
Provider Name (Legal Business Name): BRIANNE MERLESE WEAVER MM, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N PARK RD STE 400
HOLLYWOOD FL
33021-6918
US

IV. Provider business mailing address

7223 W SUNRISE BLVD APT C1
PLANTATION FL
33313-4441
US

V. Phone/Fax

Practice location:
  • Phone: 954-925-3191
  • Fax:
Mailing address:
  • Phone: 321-917-3245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-278368
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number08551
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: