Organization
PREFERRED MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE STEPHEN BROCKMAN SR. (OWNER)
(813) 689-3140
Entity
Organization
Contact information
Practice address
1633 SOUTHWIND DR, BRANDON, FL 33510-2048
(813) 689-3140
Mailing address
PO BOX 2255, MANGO, FL 33550-2255
(813) 689-3140
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/08/2006
Last updated
06/27/2008
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