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NPI Code Detail

MEDICARE: RITA BRENNAN B.A.

MEDICARE: RITA BRENNAN B.A.
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1356478044
Entity Type Code : Individual
Provider Name (Legal Business Name) : RITA BRENNAN B.A.
Provider Business Mailing Address
First Line : 1615 MAYO ST
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33020-6540
Country : US
Telephone Number : 954-921-8276
Fax Number :
Provider Business Practice Location Address
First Line : 1957 JACKSON ST
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33020-5021
Country : US
Telephone Number : 954-449-2126
Fax Number : 954-497-3857
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 07/08/2007

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Directions to “ RITA BRENNAN B.A.” Practice Location

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