Provider Demographics
NPI:1033433156
Name:BROBECK, PATRICIA LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LYNN
Last Name:BROBECK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4526 E HIGHWAY 20
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-9755
Mailing Address - Country:US
Mailing Address - Phone:850-729-3937
Mailing Address - Fax:850-678-7406
Practice Address - Street 1:4526 E HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-9755
Practice Address - Country:US
Practice Address - Phone:850-729-3937
Practice Address - Fax:850-678-7406
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3676152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist