Healthcare Provider Details

I. General information

NPI: 1083982227
Provider Name (Legal Business Name): VERENDER BROWN RPHT, CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2011
Last Update Date: 04/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 17TH ST
SAINT CLOUD FL
34769-6017
US

IV. Provider business mailing address

3208 E COLONIAL DR SUITE # 149
ORLANDO FL
32803-5127
US

V. Phone/Fax

Practice location:
  • Phone: 407-343-7342
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number131
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: