Individual
DR. ARTHUR PAUL BROADERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2190 HIGHWAY 85 N, NICEVILLE, FL 32578-1045
(352) 867-8898
(352) 732-6282
Mailing address
PO BOX 7419, ORLANDO, FL 32891-7419
(352) 867-8898
(352) 732-6282
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
ME69348
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050074614
RAILROAD MEDICARE
FL
01
—
28253
BLUE CROSS BLUE SHIELD
FL
01
—
28253X
MEDICARE PTAN
FL
05
—
379870400
—
FL
Enumeration date
09/16/2006
Last updated
08/12/2011
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