Provider Demographics
NPI:1942611918
Name:POOLE, BRITTANY (PA-C)
Entity type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:
Last Name:POOLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-776-8580
Mailing Address - Fax:954-776-8588
Practice Address - Street 1:6333 N FEDERAL HWY STE 250
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1910
Practice Address - Country:US
Practice Address - Phone:954-776-8580
Practice Address - Fax:954-776-8588
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9107844246ZX2200X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant