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Organization
BRADENTON SURGICAL GROUP PA
Active
Organization
BRADENTON SURGICAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY M BUNCH MD (OWNER)
(941) 744-2700
Entity
Organization
Contact information
Practice address
200 3RD AVE W, STE 110, BRADENTON, FL 34205-8626
(941) 744-2700
(941) 744-2705
Mailing address
200 3RD AVE W, SUITE 110, BRADENTON, FL 34205-8626
(941) 744-2700
(941) 744-2705
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7385373
AETNA
FL
01
—
94850
BCBS
FL
01
—
CK2566
RAIL ROAD MEDICARE
FL
Enumeration date
09/26/2005
Last updated
07/21/2022
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