Individual
BRIAN E CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13100 FORT KING RD, DADE CITY, FL 33525-5294
(352) 521-1175
Mailing address
5522 18TH ST, ZEPHYRHILLS, FL 33542-4518
(813) 454-4993
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
04/25/2020
Last updated
04/25/2020
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