Healthcare Provider Details

I. General information

NPI: 1891613204
Provider Name (Legal Business Name): BRENDAN BESWILAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13001 SOUTHERN BLVD
LOXAHATCHEE FL
33470-9203
US

IV. Provider business mailing address

800 PERDIDO HEIGHTS DR
WEST PALM BEACH FL
33413-1096
US

V. Phone/Fax

Practice location:
  • Phone: 561-798-3300
  • Fax:
Mailing address:
  • Phone: 561-568-0339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: