Brandt, Teresa Pullara

Brandt, Teresa Pullara is an individual health care provider with primary practice located at 621 Medical Care Dr , Brandon FL 33511-5942. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Brandt, Teresa Pullara can be contacted via phone (813) 657-3330.

Contact Information

Primary practice address
621 Medical Care Dr Brandon FL 33511-5942
Phone: (813) 657-3330
Fax: (813) 657-3348
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME0038477 Florida

Profile Details

NPI number 1831197060
LBN Legal business name Brandt, Teresa Pullara
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Nov 30th, 2012 - about 13 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 1831197060 NPPES
Florida Other 30404 BC/BS
Florida MEDICAID 068641700 BC/BS

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