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Individual

BRIDGET M KINANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
315 75TH ST W, BRADENTON, FL 34209-3201
(941) 761-1616
(941) 761-3807
Mailing address
315 75TH ST W, BRADENTON, FL 34209-3201
(941) 761-1998

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9101156
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
291574000
FL
01
970026428
RAILROAD MEDICARE
01
P00121613
RAILROAD MEDICARE
Enumeration date
12/16/2005
Last updated
07/01/2010
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