Individual
ELAINE MARY BRANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
515 S KINGS AVE STE 3000, BRANDON, FL 33511-6060
(813) 681-6625
(813) 684-6043
Mailing address
PO BOX 748817, ATLANTA, GA 30374-8817
(813) 286-0333
(813) 282-1806
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
5101021419
MI
207V00000X
Obstetrics & Gynecology Physician
Primary
OS18045
FL
Other
Enumeration date
04/14/2014
Last updated
06/22/2023
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