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NPI Code Detail

MEDICARE: BRAD S LAUDICINA OD

MEDICARE: BRAD S LAUDICINA OD
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
1152W00000XOptometristOPC4710FL

General Provider Information

NPI Number : 1568719185
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRAD S LAUDICINA OD
Provider Business Mailing Address
First Line : 2003 CORTEZ RD W
Second Line :
City : BRADENTON
State : FL
Zip : 34207-1241
Country : US
Telephone Number : 941-756-2020
Fax Number : 941-756-4486
Provider Business Practice Location Address
First Line : 2003 CORTEZ RD W
Second Line :
City : BRADENTON
State : FL
Zip : 34207-1241
Country : US
Telephone Number : 941-756-2020
Fax Number : 941-756-4486
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2012
Last Update Date : 10/03/2024

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Directions to “ BRAD S LAUDICINA OD” Practice Location

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