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NPI Code Detail

MEDICARE: MRS. ROSE CALI BRADWELL PA

MEDICARE: MRS. ROSE CALI BRADWELL PA
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
1363AS0400XSurgical Physician AssistantPA9102203FL
2363A00000XPhysician AssistantPA9102203FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942478656
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROSE CALI BRADWELL PA
Provider Business Mailing Address
First Line : 3800 S OCEAN DR STE 209
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33019-2915
Country : US
Telephone Number : 800-226-8874
Fax Number :
Provider Business Practice Location Address
First Line : 3800 S OCEAN DR STE 209
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33019-2915
Country : US
Telephone Number : 305-466-9988
Fax Number : 305-466-9989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2008
Last Update Date : 05/20/2025

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Directions to “ MRS. ROSE CALI BRADWELL PA” Practice Location

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