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General NPI Number Information
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NPI Number | 1730339599
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Entity Type | Individual
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Provider Name | BRYAN BUSH MD
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Gender | Male
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 01/26/2022
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Provider Practice Location Address
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Address Line | 1500 SE MAGNOLIA EXT STE 203
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City | OCALA
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State | FL
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Zip | 34471-4461
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Country | US
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Telephone | 352-629-1378
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Fax | 352-629-1406
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Provider Business Mailing Address
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Address Line | 2405 SE 17TH ST STE 201
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City | OCALA
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State | FL
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Zip | 34471-9190
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Country | US
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Telephone | 352-690-2171
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Fax | 352-690-2171
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | MD454660
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | ME117209
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 26325
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License Number State | WV
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