Provider Demographics
NPI:1477522241
Name:FIELD, BRENDA ELAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:ELAINE
Last Name:FIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:8000 RON BEATTY BLVD
Mailing Address - Street 2:SUITE A-3
Mailing Address - City:BAREFOOT BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32976-7474
Mailing Address - Country:US
Mailing Address - Phone:772-664-1388
Mailing Address - Fax:772-664-1391
Practice Address - Street 1:8000 RON BEATTY BLVD
Practice Address - Street 2:SUITE A-3
Practice Address - City:BAREFOOT BAY
Practice Address - State:FL
Practice Address - Zip Code:32976-7474
Practice Address - Country:US
Practice Address - Phone:772-664-1388
Practice Address - Fax:772-664-1391
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 75482207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B49459Medicare UPIN