Healthcare Provider Details

I. General information

NPI: 1003753039
Provider Name (Legal Business Name): BRIGETTE JEFFRIES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6881 KINGSPOINTE PKWY STE 18
ORLANDO FL
32819-6535
US

IV. Provider business mailing address

3518 AMIGOS AVE
ORLANDO FL
32808-7402
US

V. Phone/Fax

Practice location:
  • Phone: 888-900-7779
  • Fax:
Mailing address:
  • Phone: 888-900-7779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: