Provider Demographics
NPI:1861190852
Name:LERNER, BRENDA (PSYD, RN)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:
Last Name:LERNER
Suffix:
Gender:F
Credentials:PSYD, RN
Other - Prefix:DR
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:GOLDWATER LERNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, RN, PA
Mailing Address - Street 1:1021 NE 113TH ST # 1
Mailing Address - Street 2:
Mailing Address - City:BISCAYNE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33161-6731
Mailing Address - Country:US
Mailing Address - Phone:954-328-7109
Mailing Address - Fax:
Practice Address - Street 1:1021 NE 113TH ST # 1
Practice Address - Street 2:
Practice Address - City:BISCAYNE PARK
Practice Address - State:FL
Practice Address - Zip Code:33161-6731
Practice Address - Country:US
Practice Address - Phone:954-328-7109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1070222163W00000X
FLPY8474103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No163W00000XNursing Service ProvidersRegistered Nurse