Healthcare Provider Details

I. General information

NPI: 1154516417
Provider Name (Legal Business Name): BREHMER PEDIATRICS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 05/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 MEADOWS RD SUITE 116/118
BOCA RATON FL
33486-2346
US

IV. Provider business mailing address

801 MEADOWS RD SUITE 116/118
BOCA RATON FL
33486-2346
US

V. Phone/Fax

Practice location:
  • Phone: 561-338-9615
  • Fax: 561-338-9616
Mailing address:
  • Phone: 561-338-9615
  • Fax: 561-338-9616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME86467
License Number StateFL

VIII. Authorized Official

Name: MR. NOEL BREHMER
Title or Position: VICE PRESIDENT
Credential:
Phone: 561-338-9615