Healthcare Provider Details

I. General information

NPI: 1982306668
Provider Name (Legal Business Name): BROOKE MCMURTRIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8383 N DAVIS HWY
PENSACOLA FL
32514-6039
US

IV. Provider business mailing address

8383 N DAVIS HWY
PENSACOLA FL
32514-6039
US

V. Phone/Fax

Practice location:
  • Phone: 850-494-3212
  • Fax:
Mailing address:
  • Phone: 850-494-3212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number23478
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: