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General NPI Number Information
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NPI Number | 1982569661
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Entity Type | Individual
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Provider Name | KAELA ELAINE BRYANT MSRS, RRA
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Gender | Female
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 1600 LAKELAND HILLS BLVD
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City | LAKELAND
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State | FL
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Zip | 33805-3019
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Country | US
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Telephone | 863-680-7786
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Fax |
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Provider Business Mailing Address
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Address Line | 10 GREENTREE ST
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City | HOMOSASSA
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State | FL
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Zip | 34446-5101
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Country | US
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Telephone | 352-942-9111
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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 | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number | 90312
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 243U00000X
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Taxonomy Name | Radiology Practitioner Assistant
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License Number | 180
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License Number State | FL
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