Provider Demographics
NPI:1144284902
Name:BRODNER, DAVID C (MD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:C
Last Name:BRODNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:900 NW 13TH STREET
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486
Mailing Address - Country:US
Mailing Address - Phone:561-338-3267
Mailing Address - Fax:561-391-4420
Practice Address - Street 1:10151 ENTERPRISE CENTER BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437
Practice Address - Country:US
Practice Address - Phone:561-735-8750
Practice Address - Fax:561-735-8785
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253536000Medicaid
FL207YS0012XOtherSLEEP STUDY SUBSPECIALTY
FLH39802Medicare UPIN
FL253536000Medicaid