Healthcare Provider Details

I. General information

NPI: 1285541664
Provider Name (Legal Business Name): BRIANNA SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5410 NW 88TH AVE APT C203
SUNRISE FL
33351-4882
US

IV. Provider business mailing address

5410 NW 88TH AVE APT C203
SUNRISE FL
33351-4882
US

V. Phone/Fax

Practice location:
  • Phone: 954-288-4291
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: