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1700921020
BROOKE MICHELLE PERUSSINA
ST AUGUSTINE, FL
NPI
1700921020
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Former Name
BROOKE MICHELLE MCRAE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: FL PA9102180)
Enumeration Date
2007-02-21
Last Update Date
2007-07-08
Business Address
Mrs. BROOKE MICHELLE PERUSSINA PA C
103 ANASTASIA BLVD
ST AUGUSTINE, FL 32080
Phone number: 904-825-4747
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Mailing Address
Mrs. BROOKE MICHELLE PERUSSINA PA C
973 OAK ARBOR CIRCLE
ST AUGUSTINE, FL 32084
Phone number: 904-825-0379
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