Healthcare Provider Details

I. General information

NPI: 1003909003
Provider Name (Legal Business Name): ROBERT J. BRILL MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7826 SW 60TH AVE
OCALA FL
34476
US

IV. Provider business mailing address

7826 SW 60TH AVE
OCALA FL
34476
US

V. Phone/Fax

Practice location:
  • Phone: 352-622-1377
  • Fax: 352-629-4812
Mailing address:
  • Phone: 352-622-1377
  • Fax: 352-629-4812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME43207
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME43207
License Number StateFL

VIII. Authorized Official

Name: ROBERT J BRILL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 352-622-1377