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General NPI Number Information
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NPI Number | 1669930558
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Entity Type | Individual
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Provider Name | ROLANDO MANUEL BRANLY MBBS, SC.D.
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Gender | Male
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Dates
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Enumeration Date | 03/09/2019
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Last Update Date | 04/21/2020
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Provider Practice Location Address
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Address Line | 4201 SW 67TH TER
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City | DAVIE
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State | FL
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Zip | 33314-3227
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Country | US
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Telephone | 954-604-9705
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Fax |
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Provider Business Mailing Address
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Address Line | 4201 SW 67TH TER
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City | DAVIE
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State | FL
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Zip | 33314-3227
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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 | 246QH0600X
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Taxonomy Name | Histology Specialist/Technologist
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License Number | HSE27982
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 35874
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License Number State | OK
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