MEDICARE: ERIN MICHELLE-ATKINS BRADFORD DPT

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	PT37251	FL

General Provider Information

NPI Number	:	1932801420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN MICHELLE-ATKINS BRADFORD DPT

Provider Business Mailing Address
First Line	:	169 INTEGRA SHORES DR UNIT 201
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-5574
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	169 INTEGRA SHORES DR UNIT 201
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-5574
Country	:	US
Telephone Number	:	407-765-9380
Fax Number	:

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

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	03/20/2023

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