Provider Demographics
NPI:1790724532
Name:O'BRIEN, DAVID JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:O'BRIEN
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 1:1055 37TH PL
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6551
Mailing Address - Country:US
Mailing Address - Phone:772-257-8700
Mailing Address - Fax:772-257-8705
Practice Address - Street 1:1055 37TH PL
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6551
Practice Address - Country:US
Practice Address - Phone:772-257-8700
Practice Address - Fax:772-257-8705
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 68621207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL180022110OtherINDIV RR-RAILROAD MEDICAR
FL27218YMedicare PIN
FLF40950Medicare UPIN