Organization
BRYANTS BLOOMERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL S BRYANT (PRESIDENT)
(904) 384-9937
Entity
Organization
Contact information
Practice address
2700 PARK STREET, JACKSONVILLE, FL 32205
(904) 384-9937
(904) 389-1339
Mailing address
2700 PARK STREET, JACKSONVILLE, FL 32205
(904) 384-9937
(904) 389-1339
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MZ104
BCBS
—
Enumeration date
08/21/2006
Last updated
08/22/2020
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