Individual
TINA BRUEFACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
11140 W COLONIAL DR, #3, OCOEE, FL 34761-3300
(407) 395-7040
(407) 395-7105
Mailing address
10000 W COLONIAL DR, OCOEE, FL 34761-3400
(407) 298-6950
(407) 578-2354
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA0002755
FL
363AM0700X
Medical Physician Assistant
Primary
PA2755
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00094987
RRMCR
FL
Enumeration date
08/31/2006
Last updated
09/12/2024
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