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Individual

ALLEN T BRASINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6021 NW 1ST PL, GAINESVILLE, FL 32607
(352) 331-1902
(352) 331-1906
Mailing address
6021 NW 1ST PLACE, GAINESVILLE, FL 32607
(352) 331-1902
(352) 331-1906

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0058527
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
058525400
FL
01
110058871
RAILROAD MEDICARE
FL
01
14461
BLUE CROSS BLUE SHIELD
FL
01
P00713824
RR MEDICARE
FL
Enumeration date
08/18/2005
Last updated
07/10/2009
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