Bradley, Robbie L

Bradley, Robbie L is an individual health care provider with primary practice located at 6199 W Gulf To Lake Hwy , Crystal River FL 34429-2679. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bradley, Robbie L can be contacted via phone (352) 795-0644.

Contact Information

Primary practice address
6199 W Gulf To Lake Hwy Crystal River FL 34429-2679
Phone: (352) 795-0644
Fax: (352) 795-2950
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X PAC0001893 Florida

Profile Details

NPI number 1295890762
LBN Legal business name Bradley, Robbie L
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 26th, 2006
Last updated Aug 10th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295890762 NPPES
Florida MEDICAID 290310500

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