Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 2743051 | NY |
Y | 207V00000X | Obstetrician & Gynecologist | FB7721651 | FL |
NPI | 1013234590 |
---|---|
Provider Name | Miss Angelle Brebnor |
First Address | Fort Lauderdale, FL 33308-4608 |
Second Address | Fort Lauderdale, FL 33308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2010 |
Last Update Date | 22/08/2021 |