Individual
MR. BRADLEY LASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2005 MIZELL AVE STE 2100, WINTER PARK, FL 32792-4126
(407) 599-6460
(407) 599-6461
Mailing address
2005 MIZELL AVE STE 2100, WINTER PARK, FL 32792-4126
(407) 599-6460
(407) 599-6461
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5606
MA
363A00000X
Physician Assistant
Primary
PA9111766
FL
Other
Enumeration date
02/04/2014
Last updated
11/17/2020
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