Provider Demographics
NPI:1548272529
Name:PARRY, BRYAN RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:RICHARD
Last Name:PARRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 CENTURY MEDICAL DR STE C
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2100
Mailing Address - Country:US
Mailing Address - Phone:321-268-6264
Mailing Address - Fax:321-268-6273
Practice Address - Street 1:250 HARRISON ST STE 100
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-5098
Practice Address - Country:US
Practice Address - Phone:321-268-6868
Practice Address - Fax:321-267-2713
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108776207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015650200Medicaid
FLO2663OtherMEDICARE
FLMI473OtherMEDICARE
GAG55686Medicare UPIN