Bridgett Kenetra Breeden

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

CRPS.0101416-P Issued in FL

Practice address

2062 Harebell LN
Ocoee, FL 34761-5732

Phone

(863) 242-0575

NPI assigned

Jul 8, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1639915846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2062 HAREBELL LN",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347615732",
            "telephone_number": "863-242-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2062 HAREBELL LN",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347615732",
            "telephone_number": "863-242-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEDEN",
        "first_name": "BRIDGETT",
        "middle_name": "KENETRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "FL",
            "license": "CRPS.0101416-P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadia J Bowser, PMHNP-BC
• Aleksandra Kotrina Box
• Shannon L Boyer, MD
• William Bradford, MD
• Carolina Brandan, MD
• Breck Brewer, DDS
• Brian T. Burry, O.D., P.a.
• Bridge of Independence LLC
• Davanna Bridgmohan
• Steven Lee Brint, MD

• Peer Specialist in Ocoee, FL
• Providers in Ocoee, FL by specialty
• Peer Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.