Individual
GREGORY BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8432 LOCKWOOD RIDGE RD, SARASOTA, FL 34243-2903
(941) 359-1105
(941) 359-1229
Mailing address
4399 35TH ST N, ST PETERSBURG, FL 33714-3722
(727) 526-0501
(727) 522-1408
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO 5893
FL
Other
Enumeration date
05/28/2014
Last updated
05/28/2014
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