Vickaryous, Brian Keith

Vickaryous, Brian Keith is an individual health care provider with primary practice located at 773 Stirling Center Pl , Lake Mary FL 32746-4856. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Vickaryous, Brian Keith can be contacted via phone (407) 977-4130.

Contact Information

Primary practice address
773 Stirling Center Pl Lake Mary FL 32746-4856
Phone: (407) 977-4130
Fax: (407) 977-4139
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X ME9748 Florida
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 55351 Georgia
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X ME87792 Florida

Profile Details

NPI number 1902805575
LBN Legal business name Vickaryous, Brian Keith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Apr 26th, 2023 - about 2 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 1902805575 NPPES
Florida Other ME97482 STATE OF FLORIDA

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