Provider Demographics
NPI:1861434417
Name:ROBERT BRAUNER MD PL
Entity type:Organization
Organization Name:ROBERT BRAUNER MD PL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRAUNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-979-9100
Mailing Address - Street 1:13601 BRUCE B DOWNS BLVD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613
Mailing Address - Country:US
Mailing Address - Phone:813-979-9100
Mailing Address - Fax:813-979-1175
Practice Address - Street 1:13601 BRUCE B DOWNS BLVD
Practice Address - Street 2:SUITE 121
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613
Practice Address - Country:US
Practice Address - Phone:813-979-9100
Practice Address - Fax:813-979-1175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207V00000X
FLME39272207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067627600Medicaid
FL067627600Medicaid