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BRIELLE MARIE BUCKLEY PA

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1528218815

Individual Registrant:
 BRIELLE MARIE BUCKLEY PA
Gender: F
Not Sole Proprietor

Location and contact information for practice:
801 WELLNESS WAY STE 107  SEBASTIAN, FL 32958 US
Tel: 772-226-4200  Fax: 772-581-5781

Contact information for business:
1000 36TH ST  VERO BEACH, FL 32960-4862 US
Tel: 772-567-4311  Fax: 772-563-4641

Registration Information:
NPI: 1528218815
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
TXPA07418
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
FLPA9110318

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
328101601TX05
BCBS8697NJTX01
BCBS8663NDTX01




HEALTH CARE JOBS FL - Page 1



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