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NPI Code Detail

MEDICARE: BRANDI RAY ARNP

MEDICARE:   BRANDI  RAY  ARNP
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
1363LF0000XFamily Nurse PractitionerARNP9280328FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669921714
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDI RAY ARNP
Provider Business Mailing Address
First Line : 64 LAKE LINK CIR SE
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-1038
Country : US
Telephone Number : 863-680-7000
Fax Number : 866-264-8519
Provider Business Practice Location Address
First Line : 1033 N PARKWAY FRONTAGE RD
Second Line :
City : LAKELAND
State : FL
Zip : 33803-0401
Country : US
Telephone Number : 863-647-8013
Fax Number : 863-647-8005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2016
Last Update Date : 01/06/2026

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