MRS. BRANDIE UNDERWOOD


Address: 255 Se 7th Ave Ste 3, Crystal River, FL 34429-4848
Phone: 3523022223

MRS. BRANDIE UNDERWOOD (NPI# 1538645122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1538645122
Entity Type Individual
Full Name MRS. BRANDIE UNDERWOOD
Practice Address 255 Se 7th Ave Ste 3
Crystal River
FL 34429-4848
Practice Telephone 3523022223
Mailing Telephone 3523022223
Enumeration Date 2018-07-17
Last Update Date 2018-07-17
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 247ZC0005X Pathology
Specialization: Clinical Laboratory Director, Non-physician
10D2151245 FL Technologists, Technicians & Other Technical Service Providers

Office Location

Street Address 255 SE 7TH AVE STE 3
City CRYSTAL RIVER
State FL
Zip Code 34429-4848

Providers in the same location

NPI Name Taxonomy Address Enumeration
1003420308 Neko Futhey Physician Assistant 255 Se 7th Ave Ste 3, Crystal River, FL 34429-4848 2020-09-03

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NPI Name Taxonomy Address Enumeration
1093324386 Sydney M Mergler Specialist/Technologist 315 Ne 10th St, Crystal River, FL 34429 2020-07-23
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1356864599 Jeri Leigh Anderson Family Medicine 6199 W. Gulf To Lake Hwy, Crystal River, FL 34429 2017-07-19
1982011706 Bambi Ann Heyer Nurse Practitioner 659 Ne Hwy 19 Unit 1, Crystal River, FL 34429 2014-07-14
1982977120 Life Soulutions Community/Behavioral Health 427 Ne 3rd St Ste C, Crystal River, FL 34429 2012-02-20
1073844296 Richard C Swanson,dmd Pa Clinic/Center 1815 Se Hwy 19, Crystal River, FL 34429 2010-01-28
1710116520 Albert M. Boholst Surgery 730 S.e. 5th Terrace, Crystal River, FL 34429 2009-07-14
1033353453 Claire Annette Wirt Mechanotherapist 1925 Se Hwy 19, Crystal River, FL 34429 2009-04-29
1811134067 John D. Hosner, D.d.s., P.a. Dentist 1118 N. Suncoast Blvd., Crystal River, FL 34429 2009-01-09
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Taxonomy Information

Taxonomy Code 247ZC0005X
Grouping Technologists, Technicians & Other Technical Service Providers
Classification Pathology
Specialization Clinical Laboratory Director, Non-physician

Taxonomy Definition

An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405.
Notes: Source: National Uniform Claim Committee [1/1/2007: new]

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1922626795 Sabrina Yvette Kelley Pathology 801 W Sr 436 Ste 2005, Altamonte Springs, FL 32714-3053 2020-07-08
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1912479130 Jean S Sanon Pathology 3020 High Ridge Rd Ste 600, Boynton Beach, FL 33426-8731 2018-12-28
1083117535 Quality Clinical Lab LLC Pathology 2204 Us Highway 19, Holiday, FL 34691-4351 2018-03-12
1407373368 Cheska Lee Burleson Pathology 921 39th Ave Ne, Saint Petersburg, FL 33703-5924 2017-08-23
1356867048 Kendall Ather Bryant Pathology 520 Baker St, Orlando, FL 32806 2017-08-15
1215329552 Joseph Coscia Pathology 28 Bermuda Lake Dr, Palm Beach Gardens, FL 33418-4584 2015-02-24
1942600465 Judith Mcmorris Pathology 4537 Winding River Way, Land O Lakes, FL 34639-5734 2014-09-03
1972756955 Rafael Rodriguez Pathology 8004 Nw 154th St # 197, Miami Lakes, FL 33016-5814 2008-11-04
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Competitor

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City CRYSTAL RIVER
Zip Code 34429

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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