Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | ME150330 | FL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME150330 | FL |
NPI | 1124405568 |
---|---|
Provider Name | Brian Thomas Grisez |
First Address | Oakland Park, FL 33334-3406 |
Second Address | Oakland Park, FL 33334-3406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2015 |
Last Update Date | 06/08/2021 |