Organization
GEORGE O BRICK MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUE C BRICK (OFC MANAGER)
(813) 685-1220
Entity
Organization
Contact information
Practice address
425 S KINGS AVE, BRANDON, FL 33511-5919
(813) 685-1220
Mailing address
425 S KINGS AVE, BRANDON, FL 33511-5919
(813) 685-1220
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0031731
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30165
MEDICARE ID
FL
Enumeration date
07/29/2008
Last updated
02/08/2011
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