Healthcare Provider Details

I. General information

NPI: 1033719539
Provider Name (Legal Business Name): BRIANNA HARDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2020
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4814 HAMLIN GROVES TRL
WINTER GARDEN FL
34787-4170
US

IV. Provider business mailing address

15145 HAVENCREST CIR APT 3116
WINTER GARDEN FL
34787-7169
US

V. Phone/Fax

Practice location:
  • Phone: 407-759-5376
  • Fax:
Mailing address:
  • Phone: 508-243-1829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: