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Individual
DR. MARC EDWARD BROCKMAN
Active
Individual
DR. MARC EDWARD BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT3093
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20823
BCBS OF FLORIDA
FL
01
—
20823X
MEDICARE RETIRED RAILROAD
—
01
—
20823Y
MEDICARE RETIRED RAILROAD
—
05
—
620336150
—
FL
Enumeration date
07/20/2005
Last updated
02/15/2008
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