Healthcare Provider Details

I. General information

NPI: 1710812383
Provider Name (Legal Business Name): COURTNEY BEHRENS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5621 SKYTOP DR
LITHIA FL
33547-4165
US

IV. Provider business mailing address

5621 SKYTOP DR
LITHIA FL
33547-4165
US

V. Phone/Fax

Practice location:
  • Phone: 813-571-6800
  • Fax: 813-653-7396
Mailing address:
  • Phone: 813-571-6800
  • Fax: 813-653-7396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9603824
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: