Provider Demographics
NPI:1225382674
Name:BRAD E. OREN, MD PA
Entity Type:Organization
Organization Name:BRAD E. OREN, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:E
Authorized Official - Last Name:OREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-433-0098
Mailing Address - Street 1:8198 S JOG RD
Mailing Address - Street 2:SUITE 102A
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-2900
Mailing Address - Country:US
Mailing Address - Phone:561-433-0098
Mailing Address - Fax:561-433-4775
Practice Address - Street 1:8198 S JOG RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-6900
Practice Address - Country:US
Practice Address - Phone:561-433-0098
Practice Address - Fax:561-433-4775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGS635AOtherMEDICARE PTAN