Individual
ORVILLE A BROOMFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNFA
Contact information
Practice address
400 HEALTH PARK BLVD, ST AUGUSTINE, FL 32086
(904) 824-4990
(904) 824-2226
Mailing address
PO BOX 3123, ST AUGUSTINE, FL 32085-3123
(904) 824-4990
(904) 824-2226
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN2729162
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312246800
—
FL
Enumeration date
10/31/2007
Last updated
08/05/2020
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