Individual
ELY BRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
603 N FLAMINGO RD, #261, PEMBROKE PINES, FL 33028-1023
(954) 433-5090
Mailing address
PO BOX 816967, HOLLYWOOD, FL 33081-0967
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
ME86456
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
78617
BCBS OF FL
FL
Enumeration date
01/18/2006
Last updated
10/09/2007
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