Individual
BRENT MCQUILKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1800 VIA ROYALE, 1813, JUPITER, FL 33458
(917) 916-2456
Mailing address
1800 VIA ROYALE, 1813, JUPITER, FL 33458-6984
(917) 916-2456
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9364271
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BMC019713314259
BLUE CROSS BLUE SHIELD
—
Enumeration date
02/25/2016
Last updated
02/25/2016
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