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Organization
BRADLEY D FOURAKER MD LLC
Active
Organization
BRADLEY D FOURAKER MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY D FOURAKER MD (PRESIDENT)
(813) 287-2121
Entity
Organization
Contact information
Practice address
4905 W BAY WAY PL, TAMPA, FL 33629-4833
(813) 287-2121
Mailing address
4905 W BAY WAY PL, TAMPA, FL 33629-4833
(813) 287-2121
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME60284
FL
Other
Enumeration date
11/29/2007
Last updated
07/24/2019
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