Individual
DR. MARK LOUIS BRANTLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-8737
Mailing address
PO BOX 13833, PHILADELPHIA, PA 19101-3833
(352) 273-8737
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME83377
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255830100
—
FL
Enumeration date
06/09/2006
Last updated
06/08/2015
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