BRYAN D FREDRICK MD LLC
Osteopathic Medicine at Waterview Dr, Inverness, FL

License number
Florida ME31083
Category
Osteopathic Medicine
Type
Emergency Medicine
Owner
Name: BRYAN D FREDRICK MD
Title: OWNER
Phone: (352) 726-9457
Address
Address
1409 S Waterview Dr, Inverness, FL 34450
National Provider ID: 1801106257
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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BRYAN D FREDRICK, MD, LLC

Inverness, FL

Registration:
Jun 1, 2010
Addresses:
1409 S Waterview Dr, Inverness, FL 34450 (Physical)
Inverness, FL 34451 (Mailing)
PO Box 609, Inverness, FL 34451
State ID:
L10000058375
Business type:
Florida Limited Liability Company
Managing Member:
Bryan D Fredrick (Managing Member), 1409 S Waterview Dr, Inverness, FL 34450 (Physical)
Agent:
Bryan Fredrick,1409 S Waterview Dr, Inverness, FL 34450 (Physical)
EIN:
272758410

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