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General NPI Number Information
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NPI Number | 1871599902
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Entity Type | Individual
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Provider Name | BRIAN FRANCIS BLADYKAS MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 06/14/2019
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Provider Practice Location Address
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Address Line | 8224 WASHINGTON STREET
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City | PORT RICHEY
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State | FL
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Zip | 34668-6679
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Country | US
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Telephone | 727-643-9216
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Fax | 727-220-4252
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Provider Business Mailing Address
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Address Line | 8224 WASHINGTON STREET
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City | PORT RICHEY
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State | FL
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Zip | 34668
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Country | US
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Telephone | 727-643-9216
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Fax | 727-220-4252
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101233441
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License Number State | VA
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