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Individual

SUSAN JOANNA BRAZIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
600 UNIVERSITY BLVD., SUITE-200, JUPITER, FL 33458
(561) 627-2210
(561) 627-5850
Mailing address
600 UNIVERSITY BLVD., SUITE-200, JUPITER, FL 33458
(561) 627-2210
(561) 627-5850

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA3369
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA3369
STATE LICENSE
FL
Enumeration date
09/08/2006
Last updated
07/08/2007
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