Provider Demographics
NPI:1740228121
Name:MAGRANE, BRIAN PATRICK (MD,)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:PATRICK
Last Name:MAGRANE
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 465
Mailing Address - Street 2:
Mailing Address - City:TAVERNIER
Mailing Address - State:FL
Mailing Address - Zip Code:33070-0465
Mailing Address - Country:US
Mailing Address - Phone:305-853-5214
Mailing Address - Fax:305-853-5218
Practice Address - Street 1:91550 OVERSEAS HWY
Practice Address - Street 2:SUITE 109
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070-2506
Practice Address - Country:US
Practice Address - Phone:305-853-5214
Practice Address - Fax:305-853-5218
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0086408207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57716OtherBLUE CROSS BLUE SHIELD
FLG36354Medicare UPIN
FL57716ZMedicare ID - Type UnspecifiedPROVIDER