Brunner Surgical

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

ME0046858 Issued in FL

Legal business name

BRUNNER SURGICAL

Practice address

4318 5TH Ave
Marianna, FL 32446-2182

Phone

(850) 209-4576

Fax

(850) 526-1323

NPI assigned

Jul 28, 2014

Last updated

Aug 12, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Richard G Brunner

Title

President

Phone

(850) 209-4576

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407801600000",
    "number": "1164830725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 GREEN ST",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324463345",
            "telephone_number": "850-209-4576",
            "fax_number": "850-526-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 5TH AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462182",
            "telephone_number": "850-209-4576",
            "fax_number": "850-526-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUNNER SURGICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-08-12",
        "status": "A",
        "authorized_official_last_name": "BRUNNER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-209-4576",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "ME0046858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02676",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Smith Braxton, LMHC
• Breakthru Counseling LLC
• Deloris Ann Brockner, RN, LMT
• Mary Ellen Broderick, PH.D.
• Brandrail Brown
• Anna Schack Brunner, MSN, ARNP-C
• John Garmany Brunner, D.O.
• Richard G Brunner, M.D.
• Cynthia Blackwell Bryan
• Taliyah Bryant

• Ambulatory Surgical Clinic/Center in Marianna, FL
• Providers in Marianna, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.