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General NPI Number Information
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NPI Number | 1689681561
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Entity Type | Individual
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Provider Name | ROBERT J BRUGNOLI PHD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 12/27/2018
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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 | 2466 FAIRWAY DR
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City | VERO BEACH
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State | FL
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Zip | 32960-5005
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Country | US
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Telephone | 772-532-0811
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY3156
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY3156
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License Number State | FL
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