Provider Demographics
NPI:1427035393
Name:BRODNER, ROBERT A (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:BRODNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:1411 N FLAGLER DR
Mailing Address - Street 2:SUITE 5900
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3412
Mailing Address - Country:US
Mailing Address - Phone:561-833-6388
Mailing Address - Fax:561-833-6353
Practice Address - Street 1:1411 N FLAGLER DR
Practice Address - Street 2:SUITE 5900
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3412
Practice Address - Country:US
Practice Address - Phone:561-833-6388
Practice Address - Fax:561-833-6353
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0046672207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL61463OtherPROVIDER NUMBER
FL04251300Medicaid
FL04251300Medicaid
FL9046344988Medicare ID - Type Unspecified