Healthcare Provider Details

I. General information

NPI: 1538334941
Provider Name (Legal Business Name): LINDA BRANT INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 SPRINGVIEW DR
ORLANDO FL
32803-6932
US

IV. Provider business mailing address

736 SPRINGVIEW DR
ORLANDO FL
32803-6932
US

V. Phone/Fax

Practice location:
  • Phone: 407-893-7354
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberPY6068
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberPY6068
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberPY6068
License Number StateFL

VIII. Authorized Official

Name: LINDA BRANT
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 407-893-7354