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General NPI Number Information
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NPI Number | 1689988503
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Entity Type | Organization
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Legal Business Name | CYNTHIA M. BRADLEY, M.D., P.A.
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 08/03/2010
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Provider Practice Location Address
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Address Line | 8750 SW 144TH ST SUITE 201
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City | PALMETTO BAY
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State | FL
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Zip | 33176-7296
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Country | US
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Telephone | 305-278-8440
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Fax | 305-278-8442
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Provider Business Mailing Address
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Address Line | 8750 SW 144TH ST SUITE 201
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City | PALMETTO BAY
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State | FL
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Zip | 33176-7296
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Country | US
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Telephone | 305-278-8440
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Fax | 305-278-8442
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA BRADLEY
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Credential | MD
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Telephone | 305-278-8440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME58525
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License Number State | FL
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