Provider Demographics
NPI:1396780490
Name:BRMG INC
Entity type:Organization
Organization Name:BRMG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BASIL
Authorized Official - Middle Name:SH
Authorized Official - Last Name:CHIE-FOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-995-7800
Mailing Address - Street 1:1001 NW 13TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2269
Mailing Address - Country:US
Mailing Address - Phone:561-995-7800
Mailing Address - Fax:561-394-3334
Practice Address - Street 1:1001 NW 13TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2269
Practice Address - Country:US
Practice Address - Phone:561-995-7800
Practice Address - Fax:561-394-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 50287207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0998Medicare ID - Type Unspecified