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Provider Information for 1033315239

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. GEORGIY VLADIMIROVICH BRUSOVANIK MD

Other Name:   GOSHA BRUSOVANIK
Gender: MALE

Individual NPI: 1033315239

Calendar   Last Updated:  2020-09-11
  Certification Date:  2020-09-11

Details

Name Value
NPI 1033315239
Enumeration Date 2007-06-25
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 2800 BISCAYNE BLVD STE 1010
MIAMI, FL 33137-4559
United States

Phone: 305-467-5678 | Fax: 305-821-6782
View Map External Link
Primary Practice Address 2800 BISCAYNE BLVD STE 1010
MIAMI, FL 33137-4559
United States

Phone: 305-467-5678 | Fax: 305-821-6782
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207X00000X - Orthopaedic Surgery HI MDR-4545