Healthcare Provider Details

I. General information

NPI: 1295651818
Provider Name (Legal Business Name): CAROLINE BRADOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11402 SANDPIPER AVE
WEEKI WACHEE FL
34614-1000
US

IV. Provider business mailing address

11402 SANDPIPER AVE
WEEKI WACHEE FL
34614-1000
US

V. Phone/Fax

Practice location:
  • Phone: 727-307-3007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number9518385
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WF0300X
TaxonomyFlight Registered Nurse
License Number9518385
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9518385
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: