Individual
DAVID BRUCE VIOLETTE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 SW 160TH AVE, SUITE 250, MIRAMAR, FL 33027-6308
(877) 866-7123
Mailing address
1802 BRAEBURN DRIVE, SALEM, VA 24153-7357
(540) 772-3620
(540) 725-5016
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37550
SC
208600000X
Surgery Physician
0101249818
VA
208600000X
Surgery Physician
233642
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164632931
—
VA
01
—
C09684
MEDICARE GROUP PTAN
VA
01
—
DE1779
RAILROAD GROUP PTAN
VA
Enumeration date
05/23/2007
Last updated
06/08/2015
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