Provider Demographics
NPI:1265154066
Name:APONTE, BREANNA NICHOLE
Entity type:Individual
Prefix:MS
First Name:BREANNA
Middle Name:NICHOLE
Last Name:APONTE
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 1:13638 TORTONA LN APT 1211
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-7465
Mailing Address - Country:US
Mailing Address - Phone:407-492-0301
Mailing Address - Fax:
Practice Address - Street 1:15425 SOUTHERN MARTIN ST
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4898
Practice Address - Country:US
Practice Address - Phone:407-386-3198
Practice Address - Fax:407-386-3198
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty