Provider Demographics
NPI:1386019024
Name:GILES, BRENDA (ARNP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:GILES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:SWEENEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 RAINTREE CT
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-9348
Mailing Address - Country:US
Mailing Address - Phone:863-660-0003
Mailing Address - Fax:863-965-1213
Practice Address - Street 1:5050 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2501
Practice Address - Country:US
Practice Address - Phone:863-688-3030
Practice Address - Fax:863-688-4430
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9377926363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily