Brodeur, Mark

Brodeur, Mark is an individual health care provider with primary practice located at 3625 University Blvd S Emergency Dept, Jacksonville FL 32216-4207. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Brodeur, Mark can be contacted via phone (904) 346-3606.

Contact Information

Primary practice address
3625 University Blvd S Emergency Dept Jacksonville FL 32216-4207
Phone: (904) 346-3606
Fax: (904) 346-0113
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X ME0090285 Florida

Profile Details

NPI number 1952389538
LBN Legal business name Brodeur, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2006
Last updated Jul 30th, 2008 - about 16 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 1952389538 NPPES
Florida Other 44098 BCBS
Florida Other 269864100 BCBS
Florida Other P00139639 BCBS
Florida MEDICAID 269864100 BCBS
Florida Other P00139639 BCBS
Florida MEDICAID 787365756A BCBS

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