Healthcare Provider Details

I. General information

NPI: 1831736768
Provider Name (Legal Business Name): BRIA GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 NW 13TH ST STE 100
BOCA RATON FL
33486-2342
US

IV. Provider business mailing address

880 NW 13TH ST STE 101
BOCA RATON FL
33486-2342
US

V. Phone/Fax

Practice location:
  • Phone: 561-843-8522
  • Fax: 561-687-5601
Mailing address:
  • Phone: 561-843-8522
  • Fax: 561-687-5601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAJESH BHAKTA
Title or Position: PRESIDENT
Credential:
Phone: 561-808-6700