Individual
DR. MICHAEL BRADLEY SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4211 VAN DYKE RD, #200, LUTZ, FL 33558-8005
(813) 264-6490
(813) 443-8143
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 532-1355
(813) 635-2613
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME104627
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003017701
—
FL
Enumeration date
09/11/2007
Last updated
03/22/2021
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