Provider Demographics
NPI:1780335299
Name:EDDY, BRIAN RICHARD (APRN)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:RICHARD
Last Name:EDDY
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 37TH PL STE 104
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6501
Mailing Address - Country:US
Mailing Address - Phone:772-978-5811
Mailing Address - Fax:772-978-5815
Practice Address - Street 1:1050 37TH PL STE 104
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6501
Practice Address - Country:US
Practice Address - Phone:772-978-5811
Practice Address - Fax:772-978-5815
Is Sole Proprietor?:No
Enumeration Date:2022-01-16
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11021148363LG0600X, 363L00000X
FLRN9351561163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner