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NPI Code Detail

MEDICARE: BRENDAN KEANY RN

MEDICARE: BRENDAN KEANY RN
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
1163W00000XRegistered NurseRN9421741FL
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN11044080FL

General Provider Information

NPI Number : 1811525546
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDAN KEANY RN
Provider Business Mailing Address
First Line : 2721 BORA BORA PL
Second Line :
City : HOLIDAY
State : FL
Zip : 34691-3203
Country : US
Telephone Number : 727-307-6148
Fax Number :
Provider Business Practice Location Address
First Line : 34125 US HIGHWAY 19 N STE 200
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-2115
Country : US
Telephone Number : 727-307-6148
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2020
Last Update Date : 05/19/2026

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