Provider Demographics
NPI:1225375082
Name:BRISK, NENEL (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:MRS
First Name:NENEL
Middle Name:
Last Name:BRISK
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18995 BISCAYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2818
Mailing Address - Country:US
Mailing Address - Phone:305-936-5767
Mailing Address - Fax:305-692-3787
Practice Address - Street 1:18995 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2818
Practice Address - Country:US
Practice Address - Phone:305-936-5767
Practice Address - Fax:305-692-3787
Is Sole Proprietor?:No
Enumeration Date:2013-01-13
Last Update Date:2013-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35352183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist