DR. BRENDA BOURASSA (NPI# 1184726978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184726978 |
| Entity Type | Individual |
| Full Name | DR. BRENDA BOURASSA |
| Credential | DO |
| Practice Address |
407 Se 9th St Suite 103 Fort Lauderdale FL 33316-1113 |
| Practice Telephone | 9544630112 |
| Practice Fax Number | 9544630117 |
| Mailing Telephone | 9544630112 |
| Mailing Fax Number | 9544630117 |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2016-02-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
OS7548 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 273027800 | 05 |
| Street Address |
407 SE 9TH ST SUITE 103 |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33316-1113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124120019 | Wayne Robert Kotzker | Internal Medicine | 407 Se 9th St, Suite 103, Fort Lauderdale, FL 33316-1113 | 2006-09-02 |
| 1457633018 | Lorianne English | Nurse Practitioner | 407 Se 9th St, Suite 103, Fort Lauderdale, FL 33316-1113 | 2011-09-09 |
| 1013229707 | Carlos Eliu Duran-martinez | Internal Medicine | 407 Se 9th St, Suite 103, Fort Lauderdale, FL 33316-1113 | 2010-07-09 |
| 1386828069 | Nisha Bhatt | Internal Medicine | 407 Se 9th St, Suite 103, Fort Lauderdale, FL 33316-1113 | 2007-12-18 |
| 1679772396 | Zachary L. Yablon | Internal Medicine | 407 Se 9th St, Suite 103, Fort Lauderdale, FL 33316-1113 | 2007-07-12 |
| 1306939327 | Alberto Casaretto Md Plc | Internal Medicine | 407 Se 9th St, Suite 103, Fort Lauderdale, FL 33316-1113 | 2006-10-02 |
| 1043312853 | Reinaldo Rosario | Internal Medicine | 407 Se 9th St, Suite 103, Fort Lauderdale, FL 33316-1113 | 2006-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064040 | Jonathan David Ortiz | Behavior Technician | 1717 Se 4 Ave, Fort Lauderdale, FL 33316 | 2020-05-15 |
| 1306311626 | Gateway Recovery Center, LLC | Counselor | 1421 Sw 4th Avenue, Suite B, Fort Lauderdale, FL 33316 | 2018-10-13 |
| 1588141626 | Natan Bastoky | Family Medicine | 1600 S Andrews Ave # Gme, Fort Lauderdale, FL 33316 | 2018-07-22 |
| 1104320126 | Kathleen Kanani Graham | Pharmacist | 1401 S. Federal Highway, Ft. Lauderdale, FL 33316 | 2018-03-23 |
| 1093224271 | Lacosta Therapy, LLC | Behavioral Analyst | 412 Se 15 St., #4, Ft. Lauderdale, FL 33316 | 2017-09-20 |
| 1124560370 | Yulia Rybalka | Pharmacist | 217 Se 10th Street, Ft Lauderdale, FL 33316 | 2016-11-04 |
| 1730635376 | Brian Alexander Reyes | Specialist/Technologist | 303 Se 3rd Ave, Ft Lauderdale, FL 33316 | 2016-09-01 |
| 1649726282 | Jennifer Tabares | Specialist/Technologist | 303 Southeast 3rd Av, Fort Lauderdale, FL 33316 | 2016-09-01 |
| 1609236850 | Diane Nicole Shilling | Nurse Practitioner | 1001 South Andrews Avenue, Suite 100, Ft. Lauderdale, FL 33316 | 2016-03-01 |
| 1396113239 | Victoria Rosado | Adult Companion | 150 Se 12th Street, 401(b), Fort Lauderdale, FL 33316 | 2015-09-09 |
| Find all providers in zip 33316 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508096330 | 360 Medical Pa | Internal Medicine | 2004 Ne 49th St, Fort Lauderdale, FL 33308-4524 | 2009-07-14 |
| 1245494855 | Samer Diab Agha | Internal Medicine | 6268 North Federal Hwy, Fort Lauderdale, FL 33308 | 2008-07-12 |
| 1578669925 | Gabriel A Valle | Internal Medicine | 2001 N.e. 48 Court, Suite 4, Fort Lauderdale, FL 33308 | 2006-09-15 |
| 1124120019 | Wayne Robert Kotzker | Internal Medicine | 407 Se 9th St, Suite 103, Fort Lauderdale, FL 33316-1113 | 2006-09-02 |
| 1821190703 | Alberto Casaretto | Internal Medicine | 407 Se 9th Street, Suite 103, Fort Lauderdale, FL 33316-1113 | 2006-09-02 |
| 1972618445 | South Florida Kidney Disease & Hypertension Specialists, Pa | Internal Medicine | 6268 N Federal Hwy, Fort Lauderdale, FL 33308-1904 | 2006-08-21 |
| 1124536578 | Corinne Steffen | Internal Medicine | 6268 N Federal Hwy, Fort Lauderdale, FL 33308-1904 | 2018-01-19 |
| 1699197921 | Diab Agha Kidney and Hypertension Clinic Inc | Internal Medicine | 6268 N Federal Hwy, Fort Lauderdale, FL 33308-1904 | 2014-01-06 |
| 1013229707 | Carlos Eliu Duran-martinez | Internal Medicine | 407 Se 9th St, Suite 103, Fort Lauderdale, FL 33316-1113 | 2010-07-09 |
| 1306082227 | Broward Multispecialty Group LLC | Internal Medicine | 1625 Se 3rd Ave, Suite 400, Fort Lauderdale, FL 33316-2521 | 2008-12-23 |
| Find all providers in FORT LAUDERDALE | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33316 |
Please comment or provide details below to improve the information on DR. BRENDA BOURASSA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.