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Individual

BRIAN CALDWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1800 W TENNESSEE ST STE 5, TALLAHASSEE, FL 32304-3348
(850) 264-7591
(448) 666-1807
Mailing address
1800 W TENNESSEE ST STE 5, TALLAHASSEE, FL 32304-3348
(850) 264-7591
(448) 666-1807

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
L21000063839
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G21000076703
PRIVATE PAY/RETAIL
FL
Enumeration date
08/05/2022
Last updated
03/07/2024
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