Individual
TERESA ANN BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 7TH AVE N, ST PETERSBURG, FL 33705-1300
(727) 825-1100
Mailing address
PO BOX 550643, TAMPA, FL 33655-0643
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME38319
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
221859
AMERIGROUP
FL
01
—
62383
BLUE CROSS OF FLORIDA
FL
Enumeration date
06/29/2006
Last updated
02/20/2008
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