Provider Demographics
NPI:1588628499
Name:BROWN-EUSTACHE, BRIDGETTE A (ARNP)
Entity Type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:A
Last Name:BROWN-EUSTACHE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4543
Mailing Address - Country:US
Mailing Address - Phone:954-392-3000
Mailing Address - Fax:
Practice Address - Street 1:800 E CYPRESS DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025
Practice Address - Country:US
Practice Address - Phone:954-392-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2113432363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305064500Medicaid
FLY041EOtherBCBS
FL305064500Medicaid
Q03890Medicare UPIN