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General NPI Number Information
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NPI Number | 1184041386
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Entity Type | Individual
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Provider Name | BRIAN BLUMENAUER MD
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Gender | Male
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 844 SE OCEAN BLVD
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City | STUART
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State | FL
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Zip | 34994-2473
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Country | US
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Telephone | 321-663-0301
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Fax |
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Provider Business Mailing Address
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Address Line | 1528 NE OUTRIGGER LANDINGS DR
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City | JENSEN BEACH
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State | FL
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Zip | 34957-6506
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | ME151057
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License Number State | FL
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