person
Larissa Rae Brandenburg, DO
General Practice Physician in Pensacola, Florida
NPI 1932661188

Larissa Rae Brandenburg is a General Practice Physician based in Pensacola, FL. Larissa Rae Brandenburg practices in Pensacola, FL and has the professional credentials of DO. The NPI Number for Larissa Rae Brandenburg is 1932661188 and holds a License No. 0102206224 (Florida).

The current practice location address for Larissa Rae Brandenburg is 390 San Carlos Rd Ste C, Pensacola, FL and can be reached out via phone at 850-452-5242. You can also correspond with Larissa Rae Brandenburg through the mailing address at 760 EAST AVE BLDG 3911, PENSACOLA, FL - 32508-5136 (mailing address contact number: ).

Location: 390 San Carlos Rd Ste C, Pensacola, FL, 32508-5136
person
Provider Profile Details
NPI Number
1932661188
Provider Name
Larissa Rae Brandenburg
Credential
DO
Provider Entity Type
Individual
Gender
Female
Address
390 San Carlos Rd Ste C, Pensacola, FL, 32508-5136
Phone Number
850-452-5242
Fax Number
Provider Enumeration Date
04/04/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
390 San Carlos Rd Ste C
City
State
Zip
32508-5533
Phone Number
850-452-5242
Fax Number
person
Provider Business Mailing Address Details
Address
390 San Carlos Rd Ste C
City
State
Zip
32508-5533
Phone Number
850-452-5242
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
License No.
OS18242 (Florida)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
0102206224 (Virginia)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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