Basic Information
| Provider Information | |||||||||
| NPI: | 1851029623 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUNROE | ||||||||
| FirstName: | BROOKE | ||||||||
| MiddleName: | RILEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 805 N OLIVE AVE APT 421 | ||||||||
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| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334013741 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2629601713 | ||||||||
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| Practice Location | |||||||||
| Address1: | 901 45TH ST | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618445255 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2022 | ||||||||
| LastUpdateDate: | 09/22/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0120X | NA | FL | N | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery | 363AS0400X | PA9116409 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.