Individual
MR. BRYAN T MOYNIHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.C.
Contact information
Practice address
14555 CORTEZ BLVD, BROOKSVILLE, FL 34613-6003
(352) 556-4823
(352) 556-4824
Mailing address
5400 PINEHURST DR, SPRING HILL, FL 34606-3833
(352) 277-5305
(352) 616-0926
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104935
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001348200
—
FL
01
—
P01366463
RAILROAD MEDICARE
FL
Enumeration date
03/11/2009
Last updated
11/09/2023
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