Provider Demographics
NPI:1780222786
Name:BRUDER, HUGH (PMD)
Entity type:Individual
Prefix:
First Name:HUGH
Middle Name:
Last Name:BRUDER
Suffix:
Gender:M
Credentials:PMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 SW 137TH TER
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-1132
Mailing Address - Country:US
Mailing Address - Phone:954-765-6262
Mailing Address - Fax:
Practice Address - Street 1:1625 N COMMERCE PKWY STE 300
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3206
Practice Address - Country:US
Practice Address - Phone:954-765-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG