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NPI Code Detail

MEDICARE: BRAD PORRITT HIS

MEDICARE:   BRAD  PORRITT  HIS
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
1237700000XHearing Instrument SpecialistAST1199FL

General Provider Information

NPI Number : 1477237659
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRAD PORRITT HIS
Provider Business Mailing Address
First Line : 6408 CORTEZ RD W
Second Line :
City : BRADENTON
State : FL
Zip : 34210-2605
Country : US
Telephone Number : 941-794-3505
Fax Number : 941-794-8121
Provider Business Practice Location Address
First Line : 6408 CORTEZ RD W
Second Line :
City : BRADENTON
State : FL
Zip : 34210-2605
Country : US
Telephone Number : 941-794-3505
Fax Number : 941-794-8121
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2023
Last Update Date : 06/09/2023

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Directions to “ BRAD PORRITT HIS” Practice Location

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