Broyles, Brad

Broyles, Brad is an individual health care provider with primary practice located at 2018 Talley Rd , Leesburg FL 34748-3426. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Broyles, Brad can be contacted via phone (352) 315-7500.

Contact Information

Primary practice address
2018 Talley Rd Leesburg FL 34748-3426
Phone: (352) 315-7500
Fax: (352) 360-6582
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME 0071307 Florida

Profile Details

NPI number 1629033493
LBN Legal business name Broyles, Brad
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2006
Last updated Mar 7th, 2023 - about 3 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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Identifiers

StateTypeNumberIssuer
All States NPI 1629033493 NPPES
Florida MEDICAID 263317500
Florida Other 03386

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