Healthcare Provider Details

I. General information

NPI: 1295153450
Provider Name (Legal Business Name): JEFFREY JOSEPH BRIMMER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 PONTE VEDRA PARK DR STE 150
PONTE VEDRA FL
32082-6612
US

IV. Provider business mailing address

4101 CHARLOTTE AVE STE F185
NASHVILLE TN
37209-4066
US

V. Phone/Fax

Practice location:
  • Phone: 904-849-6806
  • Fax: 833-454-1889
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPR375
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: