Gregory Broderick

Primary specialty

OpticianTaxonomy code 156FX1800X

License

DO 5893 Issued in FL

Practice address

8432 Lockwood Ridge Rd
Sarasota, FL 34243-2903

Phone

(941) 359-1105

Fax

(941) 359-1229

NPI assigned

May 28, 2014

Last updated

May 28, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1336551159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4399 35TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337143722",
            "telephone_number": "727-526-0501",
            "fax_number": "727-522-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8432 LOCKWOOD RIDGE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432903",
            "telephone_number": "941-359-1105",
            "fax_number": "941-359-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "GREGORY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-28",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO 5893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brightstar of Sarasota and Manatee
• Martin John Brinker, LAT, ATC
• William C. Briscoe, M.D.
• Candice Victoria Brockel, DPT
• Brockford D Herring Dopa
• Brad Stephen Broeder, PH.D.
• Diane Broehm
• Thomas Bronk, DO
• Gregory Bronner, D.O.
• Jacqueline Ann Brook, R.N.

• Optician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Optician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.