MEDICARE: BRENDA NAUMOVITZ APRN

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	207Q00000X	Family Medicine Physician	APRN11040438	FL
2	163WX0200X	Oncology Registered Nurse	APRN11040438	FL
3	208000000X	Pediatrics Physician	APRN11040438	FL

General Provider Information

NPI Number	:	1649162124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA NAUMOVITZ APRN

Provider Business Mailing Address
First Line	:	1474 MCGREGOR RD
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-4419
Country	:	US
Telephone Number	:	386-717-8317
Fax Number	:

Provider Business Practice Location Address
First Line	:	2884 WELLNESS AVE
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8426
Country	:	US
Telephone Number	:	386-774-0016
Fax Number	:

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

Provider Enumeration Date	:	07/17/2025
Last Update Date	:	08/08/2025

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