Bourassa, Brenda

Bourassa, Brenda is an individual health care provider with primary practice located at 407 Se 9Th St Suite 103, Fort Lauderdale FL 33316-1113. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Bourassa, Brenda can be contacted via phone (954) 463-0112.

Contact Information

Primary practice address
407 Se 9Th St Suite 103 Fort Lauderdale FL 33316-1113
Phone: (954) 463-0112
Fax: (954) 463-0117
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X OS7548 Florida

Profile Details

NPI number 1184726978
LBN Legal business name Bourassa, Brenda
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2006
Last updated Feb 16th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184726978 NPPES
Florida MEDICAID 273027800

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