Provider Demographics
NPI:1003133042
Name:BRUN, FIORELLA MELISSA
Entity Type:Individual
Prefix:
First Name:FIORELLA
Middle Name:MELISSA
Last Name:BRUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 S TREASURE DR APT 216
Mailing Address - Street 2:
Mailing Address - City:NORTH BAY VILLAGE
Mailing Address - State:FL
Mailing Address - Zip Code:33141-4320
Mailing Address - Country:US
Mailing Address - Phone:305-867-6975
Mailing Address - Fax:
Practice Address - Street 1:7800 SW 57 AVE
Practice Address - Street 2:SUITE 228
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143
Practice Address - Country:US
Practice Address - Phone:305-665-4999
Practice Address - Fax:305-665-0332
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist