Provider Demographics
NPI:1841419249
Name:RESHARD, BRENDA (FIT)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:
Last Name:RESHARD
Suffix:
Gender:F
Credentials:FIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8934 RESHARD LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-9073
Mailing Address - Country:US
Mailing Address - Phone:850-893-5978
Mailing Address - Fax:
Practice Address - Street 1:1989 CAPITAL CIRCLE NORTH EAST, SUITE 9
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-284-8062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist