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General NPI Number Information
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NPI Number | 1083277271
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Entity Type | Individual
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Provider Name | BRENNA PERZ
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Gender | Female
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 04/15/2019
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Provider Practice Location Address
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Address Line | 7350 DAIRY RD
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City | ZEPHYRHILLS
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State | FL
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Zip | 33540-1354
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Country | US
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Telephone | 813-788-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 209 W HIGHLAND ST
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City | LAKELAND
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State | FL
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Zip | 33803-1014
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Country | US
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Telephone | 863-464-0344
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 17134
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License Number State | FL
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