Healthcare Provider Details

I. General information

NPI: 1700719341
Provider Name (Legal Business Name): BRAIN & BODY RX TELEHEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 BEACHLAND BLVD STE 1 PMB2086
VERO BEACH FL
32963-1798
US

IV. Provider business mailing address

505 BEACHLAND BLVD STE 1 PMB2086
VERO BEACH FL
32963-1798
US

V. Phone/Fax

Practice location:
  • Phone: 518-866-5972
  • Fax:
Mailing address:
  • Phone: 518-866-5972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SUSAN LAMBERTSON
Title or Position: OWNER
Credential: NP
Phone: 518-866-5972