Provider Demographics
NPI:1982632469
Name:BRAND, BARRY E (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:E
Last Name:BRAND
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 1:8240 SW 160TH ST
Mailing Address - Street 2:
Mailing Address - City:VILLAGE OF PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3651
Mailing Address - Country:US
Mailing Address - Phone:305-235-5736
Mailing Address - Fax:305-662-9515
Practice Address - Street 1:9555 N KENDALL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1978
Practice Address - Country:US
Practice Address - Phone:305-273-7319
Practice Address - Fax:305-662-9515
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 25343207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL047708700Medicaid
FL110044202OtherRR MEDICARE
FL047708700Medicaid
FL92198ZMedicare ID - Type Unspecified