O'Bryan, John L

O'Bryan, John L is an individual health care provider with primary practice located at 1350 Hickory St Suite 102, Melbourne FL 32901-3224. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. O'Bryan, John L can be contacted via phone (321) 434-3455.

Contact Information

Primary practice address
1350 Hickory St Suite 102 Melbourne FL 32901-3224
Phone: (321) 434-3455
Fax: (321) 434-3456
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9103993 Florida
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA9103993 Florida

Profile Details

NPI number 1538246491
LBN Legal business name O'Bryan, John L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2006
Last updated Mar 11th, 2020 - about 6 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 1538246491 NPPES
Florida MEDICAID 292613000
Florida Other LE023
Florida Other PA9103993

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