Basic Information
| Provider Information | |||||||||
| NPI: | 1689735623 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARBAS | ||||||||
| FirstName: | BREANN | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 911 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | TRENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326933239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3524632374 | ||||||||
| FaxNumber: | 3524632726 | ||||||||
| Practice Location | |||||||||
| Address1: | 550 GEORGIA ST | ||||||||
| Address2: | |||||||||
| City: | STARKE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 320911816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043642900 | ||||||||
| FaxNumber: | 9043642901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2006 | ||||||||
| LastUpdateDate: | 07/07/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA9105935 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.