Healthcare Provider Details

I. General information

NPI: 1104747807
Provider Name (Legal Business Name): BRITTANY PETERGAY PADMORE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 AVENUE U
BROOKLYN NY
11223
US

IV. Provider business mailing address

7040 WATSEKA AVE
ORLANDO FL
32818-1259
US

V. Phone/Fax

Practice location:
  • Phone: 718-717-8337
  • Fax:
Mailing address:
  • Phone: 407-684-1792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number994583
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: