# BRADLEY D FOURAKER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1467445866
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME0060284 | FL | Yes |
| 207WX0120X | Cornea and External Diseases Specialist Physician | ME60284 | FL | — |

## Other

- **Enumeration date:** 08/31/2005
- **Last updated:** 07/24/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0498749 | GHI | NY |
| 01 | — | 14958 | BCBS FORIDA | FL |
| 01 | — | 1674799 | CIGNA | FL |
| 01 | — | 2439747 | AETNA | FL |
| 05 | — | 370277400 | — | FL |
| 01 | — | 4414165 | AETNA | FL |