Individual
DAVID J BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1865 LIME ST STE 101, FERNANDINA BEACH, FL 32034-4779
(904) 634-0640
(904) 634-0203
Mailing address
705 WELLS RD STE 300, ORANGE PARK, FL 32073-2982
(904) 282-6331
(904) 619-1080
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA91117347
FL
363AM0700X
Medical Physician Assistant
PA9111734
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9111734
PA
FL
Enumeration date
10/22/2018
Last updated
09/01/2022
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