Provider Demographics
NPI:1790752699
Name:DEONARINE, BRIAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:J
Last Name:DEONARINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1285 36TH STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6588
Mailing Address - Country:US
Mailing Address - Phone:772-562-9923
Mailing Address - Fax:877-635-0804
Practice Address - Street 1:1285 36TH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6588
Practice Address - Country:US
Practice Address - Phone:772-562-9923
Practice Address - Fax:877-635-0804
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2012-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0072762207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10731790OtherCAQH
060055374OtherRAILROAD MEDICARE
38042OtherBLUE CROSS BLUE SHIELD
38042CMedicare ID - Type Unspecified
060055374OtherRAILROAD MEDICARE