Individual
MRS. BROOKE MICHELLE PERUSSINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
103 ANASTASIA BLVD, ST AUGUSTINE, FL 32080
(904) 825-4747
(904) 825-2885
Mailing address
973 OAK ARBOR CIRCLE, ST AUGUSTINE, FL 32084
(904) 825-0379
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9102180
FL
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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