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General NPI Number Information
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NPI Number | 1588625909
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Entity Type | Individual
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Provider Name | BRAD H DOUGLAS MD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 601 E ROLLINS ST FLORIDA HOSPITAL OB SPECIALISTS
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City | ORLANDO
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State | FL
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Zip | 32803-1248
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Country | US
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Telephone | 407-975-0406
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Fax | 407-975-0407
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Provider Business Mailing Address
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Address Line | 1801 LEE RD STE 165
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City | WINTER PARK
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State | FL
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Zip | 32789-2127
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Country | US
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Telephone | 407-975-0406
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Fax | 407-975-0407
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101057909
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 0101057909
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME118938
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 51110
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2014-00156
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD36587
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License Number State | SC
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