Provider Demographics
NPI:1689662025
Name:BRENNAN, ROBERT F (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:BRENNAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 SEMINOLE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2836
Mailing Address - Country:US
Mailing Address - Phone:321-637-3002
Mailing Address - Fax:321-637-3024
Practice Address - Street 1:1133 SEMINOLE DR
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2836
Practice Address - Country:US
Practice Address - Phone:321-637-3002
Practice Address - Fax:321-637-3024
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97563207XS0106X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00373804OtherRAIL ROAD MEDICARE
FL276911500Medicaid
G33140Medicare UPIN
FL276911500Medicaid