MEDICARE: DR. CLAYTON E. BREDLAU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	ME47532	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	060069360	OTHER	FL	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	58494	OTHER	FL	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124010335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLAYTON E. BREDLAU M.D.

Provider Business Mailing Address
First Line	:	PO BOX 5699
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34277-5699
Country	:	US
Telephone Number	:	941-365-0433
Fax Number	:	941-954-2064

Provider Business Practice Location Address
First Line	:	1215 S EAST AVE STE 303
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-2354
Country	:	US
Telephone Number	:	941-365-0433
Fax Number	:	941-954-2064

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	12/04/2018

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Directions to “ DR. CLAYTON E. BREDLAU M.D.” Practice Location

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