Brantly, Mark Louis
Brantly, Mark Louis is an individual health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-3003. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Brantly, Mark Louis can be contacted via phone (352) 273-8737.Contact Information
Primary practice address
1600 Sw Archer Rd
Gainesville FL 32610-3003
Phone: (352) 273-8737
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | ME83377 | Florida |
Profile Details
| NPI number | 1619918646 |
|---|---|
| LBN Legal business name | Brantly, Mark Louis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2006 |
| Last updated | Jun 8th, 2015 - about 9 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 | 1619918646 | NPPES |
| Florida | MEDICAID | 255830100 |
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