Healthcare Provider Details

I. General information

NPI: 1669498564
Provider Name (Legal Business Name): BRUCE HOWARD MURRAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 06/19/2023
Certification Date: 06/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 37TH PLACE SUITE 103
VERO BEACH FL
32960
US

IV. Provider business mailing address

920 37TH PLACE SUITE 103
VERO BEACH FL
32960
US

V. Phone/Fax

Practice location:
  • Phone: 772-226-6461
  • Fax: 772-226-6460
Mailing address:
  • Phone: 772-226-6461
  • Fax: 772-226-6460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number4301059880
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: