Healthcare Provider Details

I. General information

NPI: 1023927258
Provider Name (Legal Business Name): DR. BRIAN L MCNAMARA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 GREEN RD
DEERFIELD BEACH FL
33064-1080
US

IV. Provider business mailing address

872 NE 40TH ST # A
OAKLAND PARK FL
33334-3014
US

V. Phone/Fax

Practice location:
  • Phone: 954-361-8274
  • Fax:
Mailing address:
  • Phone: 201-317-0422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT45392
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: