Provider Demographics
NPI:1962520890
Name:FREDRIC S. BRANDT, M.D.,P.A
Entity type:Organization
Organization Name:FREDRIC S. BRANDT, M.D.,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:FRANCESCA
Authorized Official - Last Name:ROBLERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-443-6606
Mailing Address - Street 1:4425 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1837
Mailing Address - Country:US
Mailing Address - Phone:305-443-6606
Mailing Address - Fax:305-443-4890
Practice Address - Street 1:4425 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1837
Practice Address - Country:US
Practice Address - Phone:305-443-6606
Practice Address - Fax:305-443-4890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty