Individual
MR. JONATHAN JAMES BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
745 CHESTWOOD CHASE DR, ORANGE PARK, FL 32065-2580
(904) 214-6561
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 9103821
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292826400
—
FL
Enumeration date
03/23/2006
Last updated
03/11/2009
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