MEDICARE: DR. BRYAN T ORONSKY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME89664	FL

General Provider Information

NPI Number	:	1437266178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYAN T ORONSKY M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 55065
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-2750
Country	:	US
Telephone Number	:	904-727-7733
Fax Number	:	904-727-7737

Provider Business Practice Location Address
First Line	:	3101 UNIVERSITY BLVD. S
Second Line	:	SUITE 100
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-2750
Country	:	US
Telephone Number	:	904-727-7733
Fax Number	:	904-727-7737

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	07/08/2007

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