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NPI Code Detail

MEDICARE: KYRA BRADEN

MEDICARE:   KYRA  BRADEN
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
1224Z00000XOccupational Therapy AssistantOTA14510FL

General Provider Information

NPI Number : 1548646607
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYRA BRADEN
Provider Business Mailing Address
First Line : 3011 WOOLRIDGE DR
Second Line :
City : ORLANDO
State : FL
Zip : 32837-9063
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3011 WOOLRIDGE DR
Second Line :
City : ORLANDO
State : FL
Zip : 32837-9063
Country : US
Telephone Number : 947-282-3277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2015
Last Update Date : 12/01/2016

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Directions to “ KYRA BRADEN ” Practice Location

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