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NPI Code Detail

MEDICARE: BRIAN JAMES GRANT PA-C

MEDICARE: BRIAN JAMES GRANT PA-C
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
1363A00000XPhysician Assistant9111333FL

General Provider Information

NPI Number : 1720573462
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN JAMES GRANT PA-C
Provider Business Mailing Address
First Line : 717 SEAGATE DR
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33483-6613
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 402 SE 6TH AVE
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33483-5231
Country : US
Telephone Number : 855-636-9242
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2018
Last Update Date : 06/26/2018

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Directions to “ BRIAN JAMES GRANT PA-C” Practice Location

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