Individual
OLEG BRUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1600 SARNO RD, MELBOURNE, FL 32935-4938
(800) 348-4565
(888) 468-6511
Mailing address
3100 W END AVE, NASHVILLE, TN 37203-1320
(615) 345-5400
(888) 468-6511
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9100709
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291639800
—
FL
Enumeration date
01/09/2007
Last updated
09/16/2016
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