Healthcare Provider Details

I. General information

NPI: 1063611226
Provider Name (Legal Business Name): BRADLEY JOHN SCHULTE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 JOHNSON ST
HOLLYWOOD FL
33021-5421
US

IV. Provider business mailing address

201 E SAMPLE RD
DEERFIELD BEACH FL
33064-3502
US

V. Phone/Fax

Practice location:
  • Phone: 954-673-3793
  • Fax:
Mailing address:
  • Phone: 954-941-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOS10150
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS10150
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: