Organization
RICHARD S BRAGG MD PA
Active
Parent organization
RICHARD S BRAGG MD PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
RICHARD S BRAGG MD PA
Authorized official
RICHARD BRAGG MD (PRESIDENT)
(407) 805-8989
Entity
Organization
Contact information
Practice address
580 RINEHART RD, SUITE 110, LAKE MARY, FL 32746-1551
(407) 805-8989
Mailing address
580 RINEHART RD, SUITE 110, LAKE MARY, FL 32746-1551
(407) 805-8989
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ME0065139
FL
Other
Enumeration date
10/18/2011
Last updated
10/18/2011
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