Individual
BRADY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
200 SE HOSPITAL AVE, STUART, FL 34994-2346
(772) 287-5200
Mailing address
200 SE HOSPITAL AVE, STUART, FL 34994-2346
(772) 287-5200
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
PS52147
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194790055
—
FL
Enumeration date
07/03/2020
Last updated
07/03/2020
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