Individual
DR. BRYAN KEITH BOTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 LEE RD STE 165, WINTER PARK, FL 32789-2127
(407) 922-7691
(407) 975-0407
Mailing address
1801 LEE RD STE 165, WINTER PARK, FL 32789-2127
(407) 922-7691
(407) 975-0407
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME119694
FL
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
29899
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43105
ANTHEM BC AND BS
KY
Enumeration date
03/14/2007
Last updated
03/04/2019
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