Provider Demographics
NPI:1730717588
Name:PROBASCO, BRIANNA LINDSAY (MD)
Entity type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:LINDSAY
Last Name:PROBASCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 SW 142ND AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-1536
Mailing Address - Country:US
Mailing Address - Phone:786-423-2271
Mailing Address - Fax:
Practice Address - Street 1:4960 SW 72ND AVE STE 301
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-5549
Practice Address - Country:US
Practice Address - Phone:877-832-2652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-28
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME170838207R00000X, 207RH0002X
TXV7621207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine