Healthcare Provider Details

I. General information

NPI: 1366704124
Provider Name (Legal Business Name): RENEE MARIE BREITENBACH ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2012
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SE OCEAN BLVD STE 7
STUART FL
34994-2214
US

IV. Provider business mailing address

1 SE OCEAN BLVD STE 7
STUART FL
34994-2214
US

V. Phone/Fax

Practice location:
  • Phone: 772-919-9830
  • Fax: 772-519-5342
Mailing address:
  • Phone: 772-919-9830
  • Fax: 772-519-5342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9262538
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9262538
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: