Healthcare Provider Details

I. General information

NPI: 1649162124
Provider Name (Legal Business Name): BRENDA NAUMOVITZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2884 WELLNESS AVE
ORANGE CITY FL
32763-8426
US

IV. Provider business mailing address

1474 MCGREGOR RD
DELAND FL
32720-4419
US

V. Phone/Fax

Practice location:
  • Phone: 386-774-0016
  • Fax:
Mailing address:
  • Phone: 386-717-8317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPRN11040438
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberAPRN11040438
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberAPRN11040438
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: