Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | ME87091 | FL |
Y | 208200000X | Surgeon | ME87091 | FL |
Y | 208600000X | Surgeon | ME87091 | FL |
NPI | 1174528087 |
---|---|
Provider Name | Dr. Robert L. Brenner |
First Address | Sarasota, FL 34238-4486 |
Second Address | Sarasota, FL 34238-4486 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 14/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4067331 | AETNA PROVIDER # (01) | FL |
D76433 | (02) | FL |
K6204 | GROUP NUMBER (01) | FL |
P00133143 | RR MEDICARE (01) | FL |
P00389567 | RAILROAD MEDICARE (01) | FL |