Individual
MR. BRAD TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7025 BERACASA WAY STE 202A, BOCA RATON, FL 33433-3459
(561) 765-7960
Mailing address
7025 BERACASA WAY STE 202A, BOCA RATON, FL 33433-3459
(561) 765-7960
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
372600000X
Adult Companion
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30212454
FLORIDA NURSE REGISTRY LICENSE
FL
Enumeration date
12/19/2022
Last updated
12/19/2022
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