MEDICARE: MR. ROBERT ALAN BRODY D.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	1223G0001X	General Practice Dentistry	22DI03008600	NJ
2	1223G0001X	General Practice Dentistry	063744	NY
3	1223G0001X	General Practice Dentistry	13934	CT
4	1223G0001X	General Practice Dentistry	DN10219	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295830438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT ALAN BRODY D.M.D.

Provider Business Mailing Address
First Line	:	20295 NW 2ND AVE
Second Line	:	SUITE 202
City	:	MIAMI
State	:	FL
Zip	:	33169-2550
Country	:	US
Telephone Number	:	305-652-6313
Fax Number	:	305-652-9940

Provider Business Practice Location Address
First Line	:	140 S UNIVERSITY DR
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33025-2234
Country	:	US
Telephone Number	:	954-431-0004
Fax Number	:	954-431-6194

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

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	03/13/2024

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Directions to “ MR. ROBERT ALAN BRODY D.M.D.” Practice Location

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