Provider Demographics
NPI:1417114737
Name:ROOSE, BRANDY MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:BRANDY
Middle Name:MICHELLE
Last Name:ROOSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:102 WOODMONT BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5250
Mailing Address - Country:US
Mailing Address - Phone:888-987-1151
Mailing Address - Fax:
Practice Address - Street 1:4520 E BAY DR
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-5714
Practice Address - Country:US
Practice Address - Phone:727-615-3032
Practice Address - Fax:727-615-2195
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME110547207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFM910ZMedicare PIN