Provider Demographics
NPI:1255893608
Name:BRYAN, DEAN LEE
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:LEE
Last Name:BRYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9672 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-4642
Mailing Address - Country:US
Mailing Address - Phone:727-846-7474
Mailing Address - Fax:727-233-2922
Practice Address - Street 1:9672 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-4642
Practice Address - Country:US
Practice Address - Phone:727-846-7474
Practice Address - Fax:727-233-2922
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist