Provider Demographics
NPI:1629672969
Name:FIEBIGER, BROOK (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BROOK
Middle Name:
Last Name:FIEBIGER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 SABAL PALM DR APT 401
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-5948
Mailing Address - Country:US
Mailing Address - Phone:701-789-1594
Mailing Address - Fax:
Practice Address - Street 1:2240 E SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-2543
Practice Address - Country:US
Practice Address - Phone:954-566-8309
Practice Address - Fax:954-566-4947
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS53701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist