Individual
BRIAN ALLEN BRUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1150 N 35TH AVE STE 440, HOLLYWOOD, FL 33021-5430
(954) 265-6356
(954) 985-5154
Mailing address
2900 CORPORATE WAY, DOOR D, MIRAMAR, FL 33025-3925
(954) 276-5685
(954) 985-7074
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
30631
MS
204F00000X
Transplant Surgery Physician
66242
TN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
30631
MS
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
66242
TN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
K7670
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME141685
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107116700
—
FL
Enumeration date
01/23/2006
Last updated
09/09/2022
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