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Physician Compare National (NPI:1740280759)

HEALTHCARE PROVIDER: BRADLEY A HABUDA DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1740280759
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5799710190
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20051005000130
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name HABUDA
Individual professional last name
Provider First Name BRADLEY
Individual professional first name
Provider Middle Name ALBERT
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.
Provider Credential Text DPM
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Individual professional's medical school
Graduation Year 2002
Individual professional's medical school graduation year
Primary Specialty PODIATRY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name IRBF INC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 2062447600
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 2
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 16251 N CLEVELAND AVE
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 7
Group Practice or individual's line 2 address
City NORTH FORT MYERS
Group Practice or individual's city
State FL
Group Practice or individual's state
Zip Code 339032176
Group Practice or individual's zip code (9 digits when available)
Phone Number 2396566565
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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