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General NPI Number Information
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NPI Number | 1417874793
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Entity Type | Individual
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Provider Name | BRENTON BRENDON BENNETT RN
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Gender | Male
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 18680 SW 376TH ST # 101
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City | FLORIDA CITY
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State | FL
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Zip | 33034-6304
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Country | US
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Telephone | 786-349-6020
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Fax |
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Provider Business Mailing Address
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Address Line | 1539 SE 27TH ST UNIT 101 101
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City | HOMESTEAD
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State | FL
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Zip | 33035-2503
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Country | US
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Telephone | 786-650-8108
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9707955
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License Number State | FL
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