Healthcare Provider Details

I. General information

NPI: 1194899641
Provider Name (Legal Business Name): CONNIE J BRAUN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 03/27/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3389 MARINER BLVD
SPRING HILL FL
34609-2461
US

IV. Provider business mailing address

5400 PINEHURST DR
SPRING HILL FL
34606-3833
US

V. Phone/Fax

Practice location:
  • Phone: 352-277-5462
  • Fax: 352-691-5072
Mailing address:
  • Phone: 352-277-5305
  • Fax: 352-616-0926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME158305
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: