| Organization Name: | BRUNNER SURGICAL |
| NPI Number: | 1164830725 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RICHARD G BRUNNER (PRESIDENT) |
| Mailing Address: | 4318 5th Ave Marianna |
| State: | FL US |
| Postal Code: | 324462182 |
| Phone Number: | 8502094576 |
| Fax Number: | 8505261323 |
| NPI Enumeration Date: | 07/28/2014 |
| NPI Last Update Date: | 08/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | ME0046858 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |