Healthcare Provider Details

I. General information

NPI: 1447701529
Provider Name (Legal Business Name): FRANCEE BRODY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 10/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 KUHL AVE STE 103
ORLANDO FL
32806-2004
US

IV. Provider business mailing address

1802 KUHL AVE STE 103
ORLANDO FL
32806-2004
US

V. Phone/Fax

Practice location:
  • Phone: 407-839-0096
  • Fax:
Mailing address:
  • Phone: 407-839-0096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS0005776
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: