Provider Demographics
NPI:1194272401
Name:BRADLEY, JAMES E II (RN, CSFA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:BRADLEY
Suffix:II
Gender:M
Credentials:RN, CSFA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4944 OAKWAY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-7974
Mailing Address - Country:US
Mailing Address - Phone:904-885-5363
Mailing Address - Fax:
Practice Address - Street 1:4944 OAKWAY DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-7974
Practice Address - Country:US
Practice Address - Phone:904-885-5363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical