Provider Demographics
NPI:1992478200
Name:FARNSWORTH, BRIGITTE ELIZABETH (FNP)
Entity type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:ELIZABETH
Last Name:FARNSWORTH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6141 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6021
Mailing Address - Country:US
Mailing Address - Phone:786-655-3466
Mailing Address - Fax:
Practice Address - Street 1:6141 GRANT ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-6021
Practice Address - Country:US
Practice Address - Phone:786-655-3466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-01
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11012475207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine