Individual provider Active NPI

Amanda Brendemuehl, MS, ATC, LAT

  • Athletic Trainer
  • Haines City, FL
National Provider Identifier
1770936205
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL 2613 Issued in FL
Practice address
1027 Mandarin Way
Haines City, FL 33844-6314
Phone
(507) 339-3629
NPI assigned
Jul 20, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL 2613 FL Primary

Addresses

Primary practice location

1027 Mandarin Way
Haines City, FL 33844-6314

Mailing address

1027 Mandarin Way
Haines City, FL 33844-6314
Phone (507) 339-3629

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
AL 2613FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1770936205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 MANDARIN WAY",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338446314",
            "telephone_number": "507-339-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 MANDARIN WAY",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338446314",
            "telephone_number": "507-339-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENDEMUEHL",
        "first_name": "AMANDA",
        "name_prefix": "Ms.",
        "credential": "MS, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL 2613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haines City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.