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Individual

MR. BRENT SUMMERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1300 MICCOSUKEE RD, TALLAHASSEE, FL 32308-5054
(850) 431-5134
Mailing address
4529 RIVERS LANDING DR, TALLAHASSEE, FL 32303-8967
(386) 916-1055

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9118298
FL

Other

Enumeration date
01/03/2024
Last updated
01/03/2024
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