Provider Demographics
NPI:1811779069
Name:BEARD, BRITNEY (OD)
Entity type:Individual
Prefix:
First Name:BRITNEY
Middle Name:
Last Name:BEARD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10215 BLANCHARD PARK TRL APT 2325
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-4831
Mailing Address - Country:US
Mailing Address - Phone:954-319-3649
Mailing Address - Fax:
Practice Address - Street 1:3808 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5208
Practice Address - Country:US
Practice Address - Phone:407-894-7533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC6371152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty