Bradley, Trasse D.
Bradley, Trasse D. is an individual health care provider with primary practice located at 1301 Palm Ave , Jacksonville FL 32207-8432. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Technologists, Technicians & Other Technical Service Providers / Surgical Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Bradley, Trasse D. can be contacted via phone (904) 202-7300.Contact Information
Primary practice address
1301 Palm Ave
Jacksonville FL 32207-8432
Phone: (904) 202-7300
Fax: (904) 202-7433
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA9106836 | Florida |
Technologists, Technicians & Other Technical Service Providers / Surgical Assistant | 246ZC0007X | PA9106836 | Florida |
Profile Details
NPI number | 1770834764 |
---|---|
LBN Legal business name | Bradley, Trasse D. |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 1st, 2012 |
Last updated | May 5th, 2023 - about last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1770834764 | NPPES |
Florida | MEDICAID | 0087529-00 | |
Florida | MEDICAID | 003138114A |
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