Healthcare Provider Details

I. General information

NPI: 1043743982
Provider Name (Legal Business Name): BRENDA G BURNETT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2017
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8002 KING HELIE BLVD
NEW PORT RICHEY FL
34653-1435
US

IV. Provider business mailing address

2995 DREW ST FL 2
CLEARWATER FL
33759-3012
US

V. Phone/Fax

Practice location:
  • Phone: 727-841-4200
  • Fax:
Mailing address:
  • Phone: 727-841-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberOS17411
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: