Provider Demographics
NPI:1114358132
Name:BCB MEDICAL & WELLNESS SERVICES CORP
Entity Type:Organization
Organization Name:BCB MEDICAL & WELLNESS SERVICES CORP
Other - Org Name:BARBARA BRANDT ARNP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:CLAUDIA
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:305-335-5745
Mailing Address - Street 1:10719 NW 75TH ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2320
Mailing Address - Country:US
Mailing Address - Phone:305-335-5745
Mailing Address - Fax:
Practice Address - Street 1:2601 SW 37TH AVE
Practice Address - Street 2:SUITE 702
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2700
Practice Address - Country:US
Practice Address - Phone:305-648-1087
Practice Address - Fax:305-648-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-01
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9260194363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty