Individual
ROCKATONIA BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1523 SADLER RD, FERNANDINA BEACH, FL 32034-4467
(270) 277-2779
(270) 277-2779
Mailing address
700 BARRINGTON DR, FERNANDINA BEACH, FL 32034-0916
(270) 339-6179
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1851DT
KY
152W00000X
Optometrist
Primary
5319
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000725449
ANTHEM
KY
05
—
7100172600
—
KY
Enumeration date
07/14/2011
Last updated
07/21/2022
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