Provider Demographics
NPI:1558585505
Name:DAVEY, BRIAN PATRICK (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:PATRICK
Last Name:DAVEY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 WEDGEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3079
Mailing Address - Country:US
Mailing Address - Phone:561-963-2061
Mailing Address - Fax:561-369-2888
Practice Address - Street 1:1301 W BOYNTON BEACH BLVD STE 4
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-3420
Practice Address - Country:US
Practice Address - Phone:561-369-7892
Practice Address - Fax:561-369-2888
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0041021207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0041021OtherFLORIDA MEDICAL LICENSE #
FLAD1887136OtherDEA NUMBER
FLD51324Medicare UPIN