Individual
DR. RANDALL IRA BRODSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
206 2ND ST E, BRADENTON, FL 34208-1042
(941) 746-5111
(941) 745-6862
Mailing address
8374 MARKET ST, BOX 502, LAKEWOOD RANCH, FL 34202-5137
(941) 955-4101
(941) 358-9817
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
OS5172
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258671100
—
FL
01
—
OS5172
LICENSE NO
FL
01
—
P01259667
RR MEDICARE
FL
Enumeration date
11/16/2005
Last updated
11/02/2015
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