Provider Demographics
NPI:1871080275
Name:DRUYAN, BRIAN ZACHARY (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:ZACHARY
Last Name:DRUYAN
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 1:1900 N BAYSHORE DR APT 2508
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-3013
Mailing Address - Country:US
Mailing Address - Phone:516-652-6298
Mailing Address - Fax:
Practice Address - Street 1:1611 NW 12TH AVE DEPT OF
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:516-652-6298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35633OtherFLORIDA BOARD OF MEDICINE