Healthcare Provider Details

I. General information

NPI: 1861434417
Provider Name (Legal Business Name): ROBERT BRAUNER MD PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 04/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13601 BRUCE B DOWNS BLVD SUITE 121
TAMPA FL
33613
US

IV. Provider business mailing address

13601 BRUCE B DOWNS BLVD SUITE 121
TAMPA FL
33613
US

V. Phone/Fax

Practice location:
  • Phone: 813-979-9100
  • Fax: 813-979-1175
Mailing address:
  • Phone: 813-979-9100
  • Fax: 813-979-1175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME39272
License Number StateFL

VIII. Authorized Official

Name: MR. ROBERT E BRAUNER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 813-979-9100