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Individual

DR. BRET J MACDERMOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC, DACS

Contact information

Practice address
2940 MALLORY CIR, STE 205, CELEBRATION, FL 34747-1818
(407) 507-6976
(888) 808-4097
Mailing address
2940 MALLORY CIR, STE 205, CELEBRATION, FL 34747-1818
(407) 507-6976
(888) 808-4097

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1618
WA
111N00000X
Chiropractor
Primary
CH9737
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2201B
BCBS
FL
01
C0580Z
MEDICARE INDIVIDUAL
FL
Enumeration date
11/01/2006
Last updated
06/27/2016
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