Individual
BRANDON BRADDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
300 HEALTH PARK BLVD, SUITE 4000, SAINT AUGUSTINE, FL 32086-3707
(904) 824-8666
Mailing address
607 PEGGY PL, SAINT AUGUSTINE, FL 32086-7199
(904) 540-5454
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9108661
FL
Other
Enumeration date
04/23/2015
Last updated
05/31/2024
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