Provider Demographics
NPI:1740235787
Name:BRUMBACK, MICHAEL BEIRNS (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BEIRNS
Last Name:BRUMBACK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2 SHIRCLIFF WAY
Mailing Address - Street 2:SUITE 700 DEPAUL BLDG.
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4763
Mailing Address - Country:US
Mailing Address - Phone:904-389-5333
Mailing Address - Fax:904-389-5332
Practice Address - Street 1:2 SHIRCLIFF WAY
Practice Address - Street 2:SUITE 700 DEPAUL BLDG.
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4763
Practice Address - Country:US
Practice Address - Phone:904-389-5333
Practice Address - Fax:904-389-5332
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2016-12-29
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Provider Licenses
StateLicense IDTaxonomies
FLME 84983207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269052700Medicaid
FL28008ZMedicare PIN
FLH69603Medicare UPIN