Individual
LISA KAY BRUNDRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1021 N STATE ROAD 7, ROYAL PALM BEACH, FL 33411-5117
(561) 333-9331
Mailing address
1851 WOOD GLEN CIR, WEST PALM BEACH, FL 33411-6329
(561) 753-2899
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS8290
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02006
BLUECROSS BLUE SHIELD
FL
05
—
261717000
—
FL
Enumeration date
06/09/2006
Last updated
07/30/2019
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