Healthcare Provider Details
I. General information
NPI: 1447040407
Provider Name (Legal Business Name): BRENNAN LASHER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
52 UNDERWOOD ST
ORLANDO FL
32806-1110
US
IV. Provider business mailing address
1335 SLIGH BLVD MP 41
ORLANDO FL
32806
US
V. Phone/Fax
- Phone: 407-841-5145
- Fax:
- Phone: 321-841-8537
- Fax: 321-841-8537
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: