MEDICARE: DR. BRADLEY JOHN SAFRO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	262646	NY

General Provider Information

NPI Number	:	1376826883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADLEY JOHN SAFRO M.D.

Provider Business Mailing Address
First Line	:	1608 SE 3RD AVE FL 3
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2564
Country	:	US
Telephone Number	:	954-712-6355
Fax Number	:	954-888-3993

Provider Business Practice Location Address
First Line	:	950 S PINE ISLAND RD STE A-180
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-3926
Country	:	US
Telephone Number	:	954-712-6355
Fax Number	:	954-888-3993

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2011
Last Update Date	:	04/21/2026

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