Individual
BRYAN CO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
52 UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 841-3581
(321) 841-4085
Mailing address
52 UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 841-3581
(321) 841-4085
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301097585
MI
207R00000X
Internal Medicine Physician
Primary
ME117689
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105295900
—
FL
Enumeration date
09/28/2010
Last updated
09/03/2024
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