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General NPI Number Information
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NPI Number | 1093948572
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Entity Type | Organization
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Legal Business Name | BRADENTON GERIATRICS LLC
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Dates
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Enumeration Date | 08/31/2009
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Last Update Date | 08/31/2009
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Provider Practice Location Address
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Address Line | 300 RIVERSIDE DR E STE 1300
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City | BRADENTON
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State | FL
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Zip | 34208-1022
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Country | US
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Telephone | 941-750-0077
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Fax | 941-750-0017
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Provider Business Mailing Address
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Address Line | 300 RIVERSIDE DR E STE 1300
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City | BRADENTON
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State | FL
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Zip | 34208-1022
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Country | US
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Telephone | 941-750-0077
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Fax | 941-750-0017
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. JAMES P FLOYD
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Credential | D.O.
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Telephone | 941-750-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | OS10030
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License Number State | FL
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