Brenda Deforrest OD PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

FL2617 Issued in FL

Legal business name

BRENDA DEFORREST OD PA

Practice address

5006 Dr Phillips Blvd
Orlando, FL 32819-3310

Phone

(407) 289-8819

Fax

(407) 296-7121

NPI assigned

Nov 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brenda Deforrest, ODNPI 1619029303

Title

President

Phone

(407) 298-8819

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brenda Deforrest, OD, PA

  • Optometrist
  • Orlando, FL
  • NPI 1619029303
  Medicare reassignment NPD Authorized official
• Burton Ersoff, O.D.

  • Optometrist
  • Orlando, FL
  • NPI 1225184492
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754265600000",
    "number": "1477733780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5006 DR PHILLIPS BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328193310",
            "telephone_number": "407-289-8819",
            "fax_number": "407-296-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5006 DR PHILLIPS BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328193310",
            "telephone_number": "407-289-8819",
            "fax_number": "407-296-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENDA DEFORREST OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A",
        "authorized_official_last_name": "DEFORREST",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-298-8819",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "FL2617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Breedlove
• Sarah Elizabeth Brehm, MD
• Lorraine Billene Breiner, LMHC
• Haylee Breitinger, RMHCI
• Jazzilynn Breland, MSW
• Brenda Liz de Jesus Vega
• Marcus - Garcia Breneville
• Amber Nicole Brennan, APRN
• Daniel F Brennan, MD
• Dianne Mary Brennan, P.T.

• Clinic/Center in Orlando, FL
• Providers in Orlando, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.