Individual
DR. RICHARD RAYMOND BRUNELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
508 S HABANA AVE, SUITE 370, TAMPA, FL 33609-4181
(813) 873-1850
(813) 873-8046
Mailing address
508 S HABANA AVE, SUITE 370, TAMPA, FL 33609-4181
(813) 873-1850
(813) 873-8046
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME25656
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0581887-00
—
FL
Enumeration date
09/25/2006
Last updated
10/19/2011
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