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Individual

DR. SCOTT M. BRADFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 390-3600
(904) 390-3792
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945

Taxonomy

Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
ME88124
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
267403300
FL
05
886556908A
GA
Enumeration date
08/10/2006
Last updated
09/07/2011
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