Healthcare Provider Details

I. General information

NPI: 1235398611
Provider Name (Legal Business Name): ROBERT BRENES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 BATTERSON PARK RD STE 106
FARMINGTON CT
06032-2571
US

IV. Provider business mailing address

76 BATTERSON PARK RD STE 106
FARMINGTON CT
06032-2571
US

V. Phone/Fax

Practice location:
  • Phone: 203-598-6045
  • Fax: 203-879-0834
Mailing address:
  • Phone: 203-598-6045
  • Fax: 203-879-0834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number52482
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number52482
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: