MEDICARE: BRENDA MARIAN JOSEPH 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	363L00000X	Nurse Practitioner	APRN11040616	FL

General Provider Information

NPI Number	:	1710879861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA MARIAN JOSEPH APRN

Provider Business Mailing Address
First Line	:	17289 HICKORY WIND DR
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-8679
Country	:	US
Telephone Number	:	954-260-9706
Fax Number	:

Provider Business Practice Location Address
First Line	:	17289 HICKORY WIND DR
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-8679
Country	:	US
Telephone Number	:	954-260-9706
Fax Number	:

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

Provider Enumeration Date	:	07/15/2025
Last Update Date	:	02/18/2026

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