BRUNNER SURGICAL (NPI# 1164830725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164830725 |
| Entity Type | Organization |
| Organization Name | BRUNNER SURGICAL |
| Practice Address |
4318 5th Ave Marianna FL 32446-2182 |
| Mailing Address |
2919 Green St Marianna FL 32446-3345 |
| Practice Telephone | 8502094576 |
| Practice Fax Number | 8505261323 |
| Mailing Telephone | 8502094576 |
| Mailing Fax Number | 8505261323 |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2014-08-12 |
| Authorized Official Name | DR. RICHARD G BRUNNER (PRESIDENT) |
| Authorized Official Telephone | 8502094576 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
ME0046858 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | 02676 | 01 |
| Street Address |
4318 5TH AVE |
| City | MARIANNA |
| State | FL |
| Zip Code | 32446-2182 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528056223 | Steven Walter Spence | Internal Medicine | 4318 5th Ave, Marianna, FL 32446-2182 | 2005-10-07 |
| 1932675501 | Megan Gardner Tyler | Nurse Practitioner | 4318 5th Ave, Marianna, FL 32446-2182 | 2018-10-22 |
| 1427475185 | Internal Medicine Associates of Jackson Hospital | Clinic/Center | 4318 5th Ave, Marianna, FL 32446-2182 | 2014-03-19 |
| 1083035232 | Jackson County Hospital District | Clinic/Center | 4318 5th Ave, Marianna, FL 32446-2182 | 2013-12-13 |
| 1629391883 | Kimberly Miller Dykes | Nurse Practitioner | 4318 5th Ave, Marianna, FL 32446-2182 | 2010-03-02 |
| 1699916098 | Anna Schack Brunner | Nurse Practitioner | 4318 5th Ave, Marianna, FL 32446-2182 | 2009-03-13 |
| 1679608269 | Melanie Alexander | Nurse Practitioner | 4318 5th Ave, Marianna, FL 32446-2182 | 2007-02-22 |
| 1053462085 | Julie Renee Smith | Nurse Practitioner | 4318 5th Ave, Marianna, FL 32446-2182 | 2007-01-16 |
| 1417974999 | Internal Medicine Associates | Internal Medicine | 4318 5th Ave, Marianna, FL 32446-2182 | 2006-07-17 |
| 1205873841 | Internal Medicine Associates | Clinic/Center | 4318 5th Ave, Marianna, FL 32446-2182 | 2006-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962054817 | Covenant Home Health Care, LLC | Home Health | 4540 Lafayette Street, Ste. G, Marianna, FL 32446 | 2019-07-11 |
| 1063902930 | Syntha Alvarez | Assistant Behavior Analyst | 3217 Highway 71, Marianna, FL 32446 | 2018-05-15 |
| 1922528926 | Charlotte Allen | Respite Care | 4326 Deering Street, Marianna, FL 32446 | 2017-06-21 |
| 1003352097 | Jonathan Lee | Physical Therapist | 4387 Kelson Ave Apt A, Marianna, FL 32446 | 2017-01-13 |
| 1386003192 | Harold B Parker | Nurse Practitioner | Sunland Center 3700 Williams Drive, Marianna, FL 32446 | 2016-02-22 |
| 1912372756 | John Tyler Ellerbee | Nurse Practitioner | 4215 E Kelson Ave, Marianna, FL 32446 | 2015-12-04 |
| 1902206790 | Jason Williams | Spec/Tech, Cardiovascular | 3625 Fci Road, Marianna, FL 32446 | 2014-08-28 |
| 1336558238 | Rocky Mountain Holdings, LLC | Ambulance | 3689 Industrial Park Dr, Marianna, FL 32446 | 2014-08-05 |
| 1831430826 | Jantzen Wayne Whitehead | Counselor | 2860 Highway 71 N, Suite A, Marianna, FL 32446 | 2013-03-15 |
| 1336498047 | Sharon Lynn Miller | Counselor | 2933 Madison Street, Marianna, FL 32446 | 2012-09-10 |
| Find all providers in zip 32446 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396351102 | University Medical Service Association Inc | Clinic/Center | 13330 Usf Laurel Dr Fl 2, Tampa, FL 33612-6601 | 2020-09-17 |
| 1437764321 | Baptist Health Surgery Center, LLC | Clinic/Center | 1228 S Pine Island Rd Ste 220, Plantation, FL 33324-4402 | 2020-09-09 |
| 1538773890 | Asc of Trinity | Clinic/Center | 15238 Virginia Station, Odessa, FL 33556 | 2020-09-03 |
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1780292359 | Gemini Ambulatory Surgical Center Incorporated | Clinic/Center | 7661 Lake Worth Rd, Lake Worth, FL 33467-2534 | 2020-07-20 |
| 1891312815 | Sacred Heart Asc, LLC | Clinic/Center | 1890 Summit Boulevard, Suite 210, Pensacola, FL 32503 | 2020-06-26 |
| 1578188983 | Miami Beach Surgery Center, LLC | Clinic/Center | 400 W 41st St Ste 512, Miami Beach, FL 33140-3517 | 2020-06-11 |
| 1346865078 | Panhandle Outpatient Surgery Center | Clinic/Center | 1502 Creighton Rd Ste C, Pensacola, FL 32504-7143 | 2020-06-09 |
| 1033734793 | Naples Suncoast Surgery Center LLC | Clinic/Center | 2500 Goodlette Frank Rd Ste 200, Naples, FL 34103-4608 | 2020-06-09 |
| 1710501879 | Hz Surgery Center LLC | Clinic/Center | 17085 Porter Road, Suite 110, Winter Garden, FL 34787 | 2020-06-04 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on BRUNNER SURGICAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.