Individual
MELANIE LORETTA BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
101 MARKETSIDE AVE STE 405, PONTE VEDRA, FL 32081-1542
(904) 223-9100
Mailing address
40 ROYAL LAKE DR, PONTE VEDRA, FL 32081-0537
(904) 208-8724
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OS16693
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/27/2017
Last updated
08/10/2021
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