Individual
BRADLEY JOHN BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME80414
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0610645
CIGNA
FL
01
—
10467
TOTAL HEALTH CHOICE
FL
01
—
10511
DIMENSION
FL
01
—
114893
HUMANA HMO
FL
01
—
238939
AMERIGROUP
FL
05
—
268188901
—
FL
01
—
278678
WELLCARE
FL
01
—
293270
AV MED
FL
01
—
30114893
HUMANA
FL
01
—
332659
PHC
FL
01
—
3580558
AETNA
FL
01
—
37543
BCBS
FL
01
—
FP4185
BEECH STREET
FL
01
—
P3606154
OXFORD
FL
Enumeration date
07/08/2005
Last updated
04/22/2008
Update your record
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