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General NPI Number Information
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NPI Number | 1417421991
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Entity Type | Organization
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Legal Business Name | ROBERT J. BRUGNOLI, PH.D.
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 01/17/2019
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Provider Practice Location Address
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Address Line | 2770 INDIAN RIVER BLVD STE 303
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City | VERO BEACH
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State | FL
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Zip | 32960-4299
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Country | US
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Telephone | 772-226-5388
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Fax |
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Provider Business Mailing Address
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Address Line | 2770 INDIAN RIVER BLVD STE 303
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City | VERO BEACH
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State | FL
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Zip | 32960-4299
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Country | US
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Telephone | 772-226-5388
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ROBERT JOHN BRUGNOLI
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Credential | PH.D.
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Telephone | 772-532-0811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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