Healthcare Provider Details

I. General information

NPI: 1205357092
Provider Name (Legal Business Name): DAVID BRAUN MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 09/23/2020
Certification Date: 09/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 PARK BLVD N
PINELLAS PARK FL
33781-3534
US

IV. Provider business mailing address

1745 OYSTER POINT WAY
PALM HARBOR FL
34683-3431
US

V. Phone/Fax

Practice location:
  • Phone: 727-209-6677
  • Fax: 727-873-7408
Mailing address:
  • Phone: 727-209-6677
  • Fax: 727-873-7408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID TIMOTHY BRAUN
Title or Position: OWNER
Credential: MD, MBA
Phone: 727-209-6677