Individual
ELLEN ROBERTA BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
11714 S FEDERAL HWY, HOBE SOUND, FL 33455-5303
(772) 546-4116
(772) 546-5172
Mailing address
11714 SE FEDERAL HWY, HOBE SOUND, FL 33455-5303
(772) 546-4116
(772) 546-5172
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
061001178
VA
152W00000X
Optometrist
ONO4493
NJ
152W00000X
Optometrist
Primary
OPC1904
FL
Other
Enumeration date
08/30/2006
Last updated
12/02/2008
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