Individual
BRADLEY W ORVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3340 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8088
(941) 764-5858
(941) 764-1657
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601002022
MI
363A00000X
Physician Assistant
Primary
PA9110580
FL
Other
Enumeration date
01/19/2006
Last updated
02/14/2025
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