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General NPI Number Information
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NPI Number | 1831116649
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Entity Type | Individual
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Provider Name | BRIAN STEPHEN GARRA MD
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Gender | Male
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 05/09/2019
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Provider Practice Location Address
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Address Line | 10810 LAKE MINNEOLA SHRS
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City | CLERMONT
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State | FL
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Zip | 34711-9400
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Country | US
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Telephone | 301-332-9876
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Fax | 301-796-9925
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Provider Business Mailing Address
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Address Line | 8916 TONBRIDGE TER
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City | ADELPHI
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State | MD
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Zip | 20783-2052
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Country | US
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Telephone | 301-434-0506
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Fax | 301-796-9925
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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 | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | ME134315
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 042-0009657
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License Number State | VT
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