Individual
CHARLES LESLIE BRYNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
606 CHIVAS CT, ORANGE PARK, FL 32073-4227
(904) 542-3500
Mailing address
606 CHIVAS CT, ORANGE PARK, FL 32073-4227
(904) 542-3500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME61834
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271490600
—
FL
Enumeration date
05/01/2006
Last updated
10/20/2008
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