Provider Demographics
NPI:1811002546
Name:EDWARD W. BRAUN MD PA
Entity Type:Organization
Organization Name:EDWARD W. BRAUN MD PA
Other - Org Name:MIDTOWN MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-935-3221
Mailing Address - Street 1:7171 N DALE MABRY HWY
Mailing Address - Street 2:SUITE 501
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2630
Mailing Address - Country:US
Mailing Address - Phone:813-935-3221
Mailing Address - Fax:813-933-8149
Practice Address - Street 1:7171 N DALE MABRY HWY
Practice Address - Street 2:SUITE 501
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2630
Practice Address - Country:US
Practice Address - Phone:813-935-3221
Practice Address - Fax:813-933-8149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME510880207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID
FLK8310Medicare ID - Type UnspecifiedGROUP NUMBER