Provider Demographics
NPI:1558794412
Name:BRAYNE CONCEPTS, INC
Entity Type:Organization
Organization Name:BRAYNE CONCEPTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:MAUREEN
Authorized Official - Last Name:HOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:954-328-8370
Mailing Address - Street 1:8910 MIRAMAR PKWY STE 309G
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4188
Mailing Address - Country:US
Mailing Address - Phone:754-270-6322
Mailing Address - Fax:754-270-6321
Practice Address - Street 1:8910 MIRAMAR PKWY STE 309G
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-4188
Practice Address - Country:US
Practice Address - Phone:754-270-6322
Practice Address - Fax:754-270-6321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-14
Last Update Date:2022-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2509602363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGY124ZMedicare PIN