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Individual

DR. BRIAN P CORNNELL

Active
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Individual

DR. BRIAN P CORNNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME0042908
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02090
BLUE CROSS OF FLORIDA
FL
05
043847200
FL
01
300017097
RR MEDICARE
FL
Enumeration date
10/14/2005
Last updated
09/17/2012
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