MEDICARE: DR. ROBERT L. BRENNER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	ME87091	FL
2	208600000X	Surgery Physician	ME87091	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00133143	OTHER	FL	RR MEDICARE
4	P00389567	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4067331	OTHER	FL	AETNA PROVIDER #
3	K6204	OTHER	FL	GROUP NUMBER

General Provider Information

NPI Number	:	1174528087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT L. BRENNER M.D.

Provider Business Mailing Address
First Line	:	8833 ENCLAVE CT
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34238-4486
Country	:	US
Telephone Number	:	941-416-1188
Fax Number	:

Provider Business Practice Location Address
First Line	:	8833 ENCLAVE CT
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34238-4486
Country	:	US
Telephone Number	:	941-416-1188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	11/03/2025

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Directions to “ DR. ROBERT L. BRENNER M.D.” Practice Location

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