=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982061206
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GREGORY BRIAN FOREMNY M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2016
-----------------------------------------------------
Last Update Date | 02/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7636 NE 4TH CT STE 101
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33138-5278
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-985-0276
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1331 BRICKELL BAY DR APT 3205
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33131-3685
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-816-2830
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0202X
-----------------------------------------------------
Taxonomy Name | Diagnostic Radiology Physician
-----------------------------------------------------
License Number | 136511
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------