Active NPI
Brenna Eldridge, MD
- Pediatrics Physician
- Miami, FL
National Provider Identifier
1043584428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- TRN13816
- Practice address
- 3100 SW 62ND Ave
Miami, FL 33155-3009 - Phone
- (305) 666-6511
- NPI assigned
- Mar 1, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | TRN13816 | FL | Primary |
| Pediatric Hematology & Oncology Physician | 2080P0207X | 8228555-1205 | UT |
Addresses
Primary practice location
3100 SW 62ND Ave
Miami, FL 33155-3009
Mailing address
3100 SW 62ND Ave
Miami, FL 33155-3009
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TRN13816 | FL | MD | Pediatrics Physician |
| 8228555-1205 | UT | MD | Pediatric Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330560000000",
"number": "1043584428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 SW 62ND AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331553009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 SW 62ND AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331553009",
"telephone_number": "305-666-6511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDRIDGE",
"first_name": "BRENNA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-01",
"last_updated": "2012-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "TRN13816",
"primary": true
},
{
"code": "2080P0207X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Hematology-Oncology",
"state": "UT",
"license": "8228555-1205",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.