Provider Demographics
NPI:1457601957
Name:GEMENES, BREANNE TONETTE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:BREANNE
Middle Name:TONETTE
Last Name:GEMENES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3885 OAKWATER CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-6257
Mailing Address - Country:US
Mailing Address - Phone:407-851-6226
Mailing Address - Fax:407-438-0507
Practice Address - Street 1:3885 OAKWATER CIRCLE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6257
Practice Address - Country:US
Practice Address - Phone:407-816-5700
Practice Address - Fax:407-812-6766
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9256107363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00634Medicare PIN