Provider Demographics
NPI:1457007106
Name:RAY, BRIAN JAMES EDWARD (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:JAMES EDWARD
Last Name:RAY
Suffix:
Gender:M
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5317 LIMEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-1247
Mailing Address - Country:US
Mailing Address - Phone:561-323-8454
Mailing Address - Fax:
Practice Address - Street 1:701 NORTHPOINT PKWY STE 140
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1962
Practice Address - Country:US
Practice Address - Phone:561-296-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014435363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily