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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184726978 | NPPES |
| Florida | MEDICAID | 273027800 |
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