Bradley, Glendon Wayne

Bradley, Glendon Wayne is an individual health care provider with primary practice located at 930 Alicia Rd , Lakeland FL 33801-2104. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Bradley, Glendon Wayne can be contacted via phone (863) 680-1950.

Contact Information

Primary practice address
930 Alicia Rd Lakeland FL 33801-2104
Phone: (863) 680-1950
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 11010529 Florida

Profile Details

NPI number 1861098469
LBN Legal business name Bradley, Glendon Wayne
Credentials PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2020
Last updated Dec 8th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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