Organization Active NPI

Broward Physical Medicine

  • Chiropractor
  • Oakland Park, FL
National Provider Identifier
1033518436
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BROWARD PHYSICAL MEDICINE
Practice address
2121 W Oakland Park Blvd
Suit 10B
Oakland Park, FL 33311-1529
Phone
(954) 617-1011
NPI assigned
Aug 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ryan A. Grand, D.C.
Title
Presidnet
Phone
(561) 729-7092

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X FL Primary

Addresses

Primary practice location

2121 W Oakland Park Blvd
Suit 10B
Oakland Park, FL 33311-1529

Mailing address

PO Box 15888
West Palm Beach, FL 33416-5888
Phone (561) 729-7089

Other names 1

  • South Florida Spine and Rehab Centers Doing business as

National Provider Directory

National Provider Directory

Locations

2121 W Oakland Park Blvd
Ste 10B
Oakland Park, FL 33311
Phone (954) 617-1011

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1033518436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15888",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334165888",
            "telephone_number": "561-729-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 W OAKLAND PARK BLVD",
            "address_2": "SUIT 10B",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111529",
            "telephone_number": "954-617-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "GRAND",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDNET",
        "authorized_official_telephone_number": "561-729-7092",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Florida Spine and Rehab Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.