Individual provider Active NPI

Mary Brunzie, DO

  • Family Medicine Physician
  • Homosassa, FL
National Provider Identifier
1689784860
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS007346 Issued in FL
Practice address
7945 S Suncoast Blvd
Suite B
Homosassa, FL 34446-5005
Phone
(352) 382-6111
Fax
(352) 382-6112
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS007346 FL Primary

Addresses

Primary practice location

7945 S Suncoast Blvd
Suite B
Homosassa, FL 34446-5005

Mailing address

123 S Seminole Ave
Inverness, FL 34452-4735
Phone (352) 344-6481

Other identifiers 1

IdentifierTypeStateIssuer
251202500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS007346FLMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1689784860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 S SEMINOLE AVE",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524735",
            "telephone_number": "352-344-6481",
            "fax_number": "352-344-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7945 S SUNCOAST BLVD",
            "address_2": "SUITE B",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344465005",
            "telephone_number": "352-382-6111",
            "fax_number": "352-382-6112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNZIE",
        "first_name": "MARY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS007346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251202500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homosassa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.