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NPI Code Detail

MEDICARE: BRADEN ER SVCS PARTNERSHIP LLC

MEDICARE: BRADEN ER SVCS PARTNERSHIP LLC
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
1207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
272524OTHERFLBLUE SHIELD

General Provider Information

NPI Number : 1467400788
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRADEN ER SVCS PARTNERSHIP LLC
Provider Business Mailing Address
First Line : 13737 NOEL RD
Second Line : STE 1600
City : DALLAS
State : TX
Zip : 75240-1331
Country : US
Telephone Number : 469-401-2386
Fax Number : 214-712-2444
Provider Business Practice Location Address
First Line : 2020 59TH ST W
Second Line :
City : BRADENTON
State : FL
Zip : 34209-4604
Country : US
Telephone Number : 941-798-6303
Fax Number : 941-792-2956
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOSEPH H GATEWOOD
Credential : M.D.
Telephone Number : 469-401-2386
Provider Enumeration Date : 05/05/2006
Last Update Date : 12/22/2013

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Directions to “BRADEN ER SVCS PARTNERSHIP LLC ” Practice Location

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