Organization
BRENDA DEFORREST OD PA
Active
Organization
BRENDA DEFORREST OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA DEFORREST OD (PRESIDENT)
(407) 298-8819
Entity
Organization
Contact information
Practice address
5006 DR PHILLIPS BLVD, ORLANDO, FL 32819-3310
(407) 289-8819
(407) 296-7121
Mailing address
5006 DR PHILLIPS BLVD, ORLANDO, FL 32819-3310
(407) 289-8819
(407) 296-7121
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
FL2617
FL
Other
Enumeration date
11/05/2007
Last updated
08/04/2025
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