Healthcare Provider Details

I. General information

NPI: 1457636391
Provider Name (Legal Business Name): MAYA RITA BRANDT M.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2011
Last Update Date: 10/15/2026
Certification Date: 10/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 NE 21ST ST
FORT LAUDERDALE FL
33305-3614
US

IV. Provider business mailing address

2701 NE 21ST ST
FORT LAUDERDALE FL
33305-3614
US

V. Phone/Fax

Practice location:
  • Phone: 954-614-1398
  • Fax:
Mailing address:
  • Phone: 954-614-1398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: