Individual
BRANTLEY K MOLPUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 S ORANGE AVE, ORLANDO, FL 32806-2134
(407) 841-5111
(904) 346-0113
Mailing address
PO BOX 628296, ORLANDO, FL 32862-8296
(407) 741-9418
(904) 346-0113
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0067826
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27259
BCBS
FL
05
—
378392800
—
FL
01
—
930060267
RAILROAD MEDICARE
FL
Enumeration date
09/20/2006
Last updated
06/05/2008
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