Broadhead, Justin Gary

Broadhead, Justin Gary is an individual health care provider with primary practice located at 21298 Olean Blvd , Port Charlotte FL 33952-6705. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Broadhead, Justin Gary can be contacted via phone (941) 629-1181.

Contact Information

Primary practice address
21298 Olean Blvd Port Charlotte FL 33952-6705
Phone: (941) 629-1181
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 9397757 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 1011922 Texas

Profile Details

NPI number 1477076107
LBN Legal business name Broadhead, Justin Gary
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2017
Last updated Jan 21st, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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