Individual
DR. BRENDON R CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 5TH ST E, BRADENTON, FL 34208-2002
(941) 757-3521
(941) 714-0869
Mailing address
530 5TH ST E, BRADENTON, FL 34208-2002
(941) 757-3521
(941) 714-0869
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME98137
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278117400
—
FL
01
—
96779
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/27/2006
Last updated
07/24/2019
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