MEDICARE: BRETT LOVE

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1538534813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRETT LOVE

Provider Business Mailing Address
First Line	:	7518 CRANES CREEK CT
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-8709
Country	:	US
Telephone Number	:	407-480-1751
Fax Number	:

Provider Business Practice Location Address
First Line	:	7518 CRANES CREEK CT
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-8709
Country	:	US
Telephone Number	:	407-480-1751
Fax Number	:

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

Provider Enumeration Date	:	12/11/2015
Last Update Date	:	12/11/2015

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Directions to “ BRETT LOVE ” Practice Location

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