Provider Demographics
NPI:1871635383
Name:BRANLY, ROLANDO (MD)
Entity Type:Individual
Prefix:
First Name:ROLANDO
Middle Name:
Last Name:BRANLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 SW 156TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1155
Mailing Address - Country:US
Mailing Address - Phone:305-387-6801
Mailing Address - Fax:305-387-6801
Practice Address - Street 1:9111 SW 156TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1155
Practice Address - Country:US
Practice Address - Phone:305-387-6801
Practice Address - Fax:305-387-6801
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18098OtherBC/BS OF FLORIDA
FLP00227157Medicare PIN
FL18098WMedicare PIN