Individual
DR. BRAD EVAN OREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
055187
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255206000
—
FL
01
—
44431Z
MEDICARE PTAN
FL
01
—
65-0868500
TAX ID
FL
01
—
GS635A
MEDICARE PTAN
FL
Enumeration date
11/06/2006
Last updated
11/16/2018
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