MEDICARE: BREANNA MACGREGOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1053287425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREANNA MACGREGOR

Provider Business Mailing Address
First Line	:	5766 S SEMORAN BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-4818
Country	:	US
Telephone Number	:	689-284-8585
Fax Number	:

Provider Business Practice Location Address
First Line	:	5766 S SEMORAN BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-4818
Country	:	US
Telephone Number	:	689-284-8585
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2025
Last Update Date	:	01/20/2026

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Directions to “ BREANNA MACGREGOR ” Practice Location

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