Healthcare Provider Details

I. General information

NPI: 1447482278
Provider Name (Legal Business Name): BRIANNA CHRISTINE RHUE O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2009
Last Update Date: 10/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7822 N UNIVERSITY DR
TAMARAC FL
33321-2114
US

IV. Provider business mailing address

9430 TANGERINE PL APT 302
DAVIE FL
33324-4427
US

V. Phone/Fax

Practice location:
  • Phone: 954-726-0204
  • Fax: 954-721-1578
Mailing address:
  • Phone: 520-940-3081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC 004451
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: