Individual
MITCHELL BRANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 W MORENO ST, PENSACOLA, FL 32501
(850) 434-4011
Mailing address
P O BOX 409703, ATLANTA, GA 30384-7903
(770) 874-5400
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME87928
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267534000
—
FL
Enumeration date
09/25/2006
Last updated
02/06/2008
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