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Individual

BRIAN THOMAS BOGDANOWICZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
303 NO. CLYDE MORRIS BLVD., HALIFAX HEALTH MEDICAL CENTER & COMMUNITY CLINIC, DAYTONA BEACH, FL 32114-2709
(386) 425-6198
(386) 425-6197
Mailing address
PO BOX 864074, HALIFAX HEALTHCARE SYSTEMS, INC., ORLANDO, FL 32886-4074
(386) 226-4590
(386) 226-3371

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME110715
FL
207Q00000X
Family Medicine Physician
TRN15063
FL

Other

Enumeration date
05/31/2010
Last updated
03/08/2012
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