Individual
MR. BRYANT FREAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
18642 NW 67TH AVE, HIALEAH, FL 33015-2406
(551) 404-1584
Mailing address
16400 GOLF CLUB RD APT 111, WESTON, FL 33326-1668
(551) 404-1584
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA52208
FL
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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