Individual
MAXWELL CHARLES LOGAN BRAZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7530 SUNSET DR, MIAMI, FL 33143-4132
(305) 271-8790
Mailing address
7530 SUNSET DR, MIAMI, FL 33143-4132
(305) 271-8790
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T562635670580
—
FL
Enumeration date
12/15/2022
Last updated
12/15/2022
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