Provider Demographics
NPI:1316334840
Name:BRETT A OSBORN DO PLLC
Entity type:Organization
Organization Name:BRETT A OSBORN DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:A
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-935-9233
Mailing Address - Street 1:600 HERITAGE DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3000
Mailing Address - Country:US
Mailing Address - Phone:561-935-9233
Mailing Address - Fax:561-354-9314
Practice Address - Street 1:600 HERITAGE DR
Practice Address - Street 2:SUITE 105
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3000
Practice Address - Country:US
Practice Address - Phone:561-935-9233
Practice Address - Fax:561-354-9314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8838207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty