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General NPI Number Information
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NPI Number | 1689975146
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Entity Type | Individual
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Provider Name | BRADLEY AUGUST HERMS CRNA
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Gender | Male
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Dates
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Enumeration Date | 11/15/2010
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Last Update Date | 03/29/2022
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Provider Practice Location Address
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Address Line | 4932 SW BIMINI CIR N
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City | PALM CITY
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State | FL
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Zip | 34990-1232
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Country | US
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Telephone | 440-465-6733
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Fax |
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Provider Business Mailing Address
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Address Line | 4932 SW BIMINI CIR N
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City | PALM CITY
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State | FL
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Zip | 34990-1232
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Country | US
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Telephone | 440-465-6733
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 11016458
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4704248325
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License Number State | MI
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