Provider Demographics
NPI:1982359519
Name:BRAZIL, MYRTIS (BS, MA)
Entity Type:Individual
Prefix:
First Name:MYRTIS
Middle Name:
Last Name:BRAZIL
Suffix:
Gender:F
Credentials:BS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 FLAMINGO DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48601-5759
Mailing Address - Country:US
Mailing Address - Phone:989-714-3032
Mailing Address - Fax:
Practice Address - Street 1:3200 FLAMINGO DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-5759
Practice Address - Country:US
Practice Address - Phone:989-714-3032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator