MEDICARE: JOSEPH MICHAEL BRENNAN MSN, CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	RN9447278	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861917429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH MICHAEL BRENNAN MSN, CRNA

Provider Business Mailing Address
First Line	:	679 HADDON AVE FL 2
Second Line	:
City	:	COLLINGSWOOD
State	:	NJ
Zip	:	08108-3718
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7111 FAIRWAY DR STE 450
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4200
Country	:	US
Telephone Number	:	561-799-3552
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2017
Last Update Date	:	08/04/2017

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