Bradley, Rockatonia
Bradley, Rockatonia is an individual health care provider with primary practice located at 1523 Sadler Rd , Fernandina Beach FL 32034-4467. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Bradley, Rockatonia can be contacted via phone (270) 277-2779.Contact Information
Primary practice address
1523 Sadler Rd
Fernandina Beach FL 32034-4467
Phone: (270) 277-2779
Fax: (270) 277-2779
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1851DT | Kentucky |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5319 | Florida |
Profile Details
| NPI number | 1427346295 |
|---|---|
| LBN Legal business name | Bradley, Rockatonia |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2011 |
| Last updated | Jul 21st, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427346295 | NPPES |
| Kentucky | Other | 000000725449 | ANTHEM |
| Kentucky | MEDICAID | 7100172600 | ANTHEM |
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