Individual
MS. VANESSA WANDA BRUTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1425 NW 11TH ST, FORT LAUDERDALE, FL 33311-6110
(954) 410-9794
Mailing address
1425 NW 11TH ST, FORT LAUDERDALE, FL 33311-6110
(954) 410-9794
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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