Individual
BRADLEY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10000 BAY PINES BLVD, BAY PINES, FL 33744-8200
(727) 398-6661
Mailing address
4115 2ND AVE NE, BRADENTON, FL 34208-5421
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P9679
ID
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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