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General NPI Number Information
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NPI Number | 1174901458
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Entity Type | Individual
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Provider Name | KAYLAN BRADY M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/07/2015
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 70 TURIN TERRACE SUITE 220
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City | ST AUGUSTINE
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State | FL
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Zip | 32092
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Country | US
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Telephone | 904-819-3000
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Fax | 904-819-4426
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Provider Business Mailing Address
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Address Line | PO BOX 100296
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City | GAINESVILLE
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State | FL
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Zip | 32610-0296
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Country | US
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Telephone | 352-627-9350
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Fax | 352-273-9054
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME140045
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License Number State | FL
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