MEDICARE: MRS. APRIL MAY BRADWAY

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	225100000X	Physical Therapist	PT15433	FL

General Provider Information

NPI Number	:	1639349129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. APRIL MAY BRADWAY

Provider Business Mailing Address
First Line	:	1721 BELL RANCH ST
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-1704
Country	:	US
Telephone Number	:	813-643-3231
Fax Number	:

Provider Business Practice Location Address
First Line	:	1721 BELL RANCH ST
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-1704
Country	:	US
Telephone Number	:	813-643-3231
Fax Number	:

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

Provider Enumeration Date	:	03/11/2008
Last Update Date	:	03/11/2008

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