Individual
BRENDAN LALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 S ANDREWS AVE, FORT LAUDERDALE, FL 33316-2510
(954) 355-5199
Mailing address
1721 SE 17TH ST APT 451, FORT LAUDERDALE, FL 33316-3142
(727) 686-4630
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME136054
FL
Other
Enumeration date
05/07/2015
Last updated
01/15/2019
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