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General NPI Number Information
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NPI Number | 1518579663
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Entity Type | Individual
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Provider Name | PIERRE RICHARD BRENORD
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Gender | Male
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 438 W BREVARD ST
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City | TALLAHASSEE
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State | FL
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Zip | 32301-1004
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Country | US
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Telephone | 850-224-2469
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Fax |
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Provider Business Mailing Address
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Address Line | 1747 CAPITAL CIR NE APT 1001
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5566
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Country | US
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Telephone | 631-829-8241
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PACN48
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License Number State | FL
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