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Organization
AP OF BROWARD, LLC
Active
Organization
AP OF BROWARD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN TOBIAS GRAY (CHIEF EXECUTIVE OFFICER)
(954) 292-8657
Entity
Organization
Contact information
Practice address
3981 SW 30TH AVE, FORT LAUDERDALE, FL 33312-6816
(954) 292-8657
Mailing address
4220 WALLACE LN, NASHVILLE, TN 37215-3232
(954) 292-8657
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
NULL
363AS0400X
Surgical Physician Assistant
Primary
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/18/2015
Last updated
02/18/2015
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