Organization Active NPI

George O Brick MD PA

  • Family Medicine Physician
  • Brandon, FL
National Provider Identifier
1134384258
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0031731 Issued in FL
Legal business name
GEORGE O BRICK MD PA
Practice address
425 S Kings Ave
Brandon, FL 33511-5919
Phone
(813) 685-1220
NPI assigned
Jul 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Authorized official

Name
Sue C Brick
Title
Ofc Manager
Phone
(813) 685-1220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME0031731 FL Primary

Addresses

Primary practice location

425 S Kings Ave
Brandon, FL 33511-5919

Mailing address

425 S Kings Ave
Brandon, FL 33511-5919
Phone (813) 685-1220

Other identifiers 1

IdentifierTypeStateIssuer
30165OtherFLMEDICARE ID

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1134384258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115919",
            "telephone_number": "813-685-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115919",
            "telephone_number": "813-685-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE O BRICK MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "BRICK",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFC MANAGER",
        "authorized_official_telephone_number": "813-685-1220"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0031731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "30165",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.