Provider Demographics
NPI:1417553876
Name:VONBARTHELD, BRANDI ELAINE
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:ELAINE
Last Name:VONBARTHELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 ELMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691-3529
Mailing Address - Country:US
Mailing Address - Phone:727-237-5909
Mailing Address - Fax:
Practice Address - Street 1:3839 ELMWOOD DR
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-3529
Practice Address - Country:US
Practice Address - Phone:727-237-5909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator