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General NPI Number Information
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NPI Number | 1750669651
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Entity Type | Individual
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Provider Name | ANTHONY F BRILLANTE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2011
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Last Update Date | 07/26/2011
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Provider Practice Location Address
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Address Line | 1601 NW 114TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-2539
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Country | US
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Telephone | 954-431-0921
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 N,W 114TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-2539
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Country | US
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Telephone | 954-431-0921
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Fax | 954-966-3473
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME22652
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License Number State | FL
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