Individual provider · NPI-1

Brian Allen Bruckner, M.D.

Thoracic Surgery (Cardiothoracic Vascular Surgery) · Hollywood, FL

NPI number1871573097

StatusActive

Last updated in NPPESSep 9, 2022

Details

NPI: 1871573097
Entity type: Individual (NPI-1)
Name: Brian Allen Bruckner
Credential: M.D.
Sex: Male
Sole proprietor: No
Enumeration date: Jan 23, 2006
Certification date: Sep 9, 2022
Last updated: Sep 9, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery)	ME141685	FL	Yes
204F00000X	Transplant Surgery	30631	MS
204F00000X	Transplant Surgery	66242	TN
208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery)	K7670	TX
208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery)	66242	TN
208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery)	30631	MS

Practice location

1150 N 35th Ave Ste 440
Hollywood, FL 33021-5430

Phone 954-265-6356 · Fax 954-985-5154

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925

Phone 954-276-5685 · Fax 954-985-7074

Other practice locations

3501 Johnson St
Hollywood, FL 33021-5421

Phone 954-265-7750 · Fax 954-276-0280

6025 Walnut Grove Rd Ste 301
Memphis, TN 38120-2123

Phone 901-226-0456 · Fax 901-226-0458

401 Southcrest Cir Ste 201
Southaven, MS 38671-6721

Phone 901-226-0456 · Fax 901-226-0458

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