Provider Demographics
NPI:1427875756
Name:URIE, BRETT MICHAEL (APRN)
Entity type:Individual
Prefix:MR
First Name:BRETT
Middle Name:MICHAEL
Last Name:URIE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 COUNTY ROAD 466 STE 200
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-4205
Mailing Address - Country:US
Mailing Address - Phone:523-350-5130
Mailing Address - Fax:352-350-1864
Practice Address - Street 1:871 COUNTY ROAD 466 STE 200
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-4205
Practice Address - Country:US
Practice Address - Phone:352-350-5130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11034976363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily