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General NPI Number Information
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NPI Number | 1801882667
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Entity Type | Individual
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Provider Name | BRADLEY SCOTT FOSTER M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 1911 N MILLS AVE
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City | ORLANDO
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State | FL
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Zip | 32803-1407
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Country | US
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Telephone | 407-893-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 1911 N MILLS AVE
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City | ORLANDO
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State | FL
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Zip | 32803-1407
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Country | US
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Telephone | 407-893-8200
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME157141
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | ME157141
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License Number State | FL
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