Bradshaw, John R

Bradshaw, John R is an individual health care provider with primary practice located at 1600 Lakeland Hills Blvd , Lakeland FL 33805. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as his primary health care specialty. Bradshaw, John R can be contacted via phone (863) 680-7000.

Contact Information

Primary practice address
1600 Lakeland Hills Blvd Lakeland FL 33805
Phone: (863) 680-7000
Fax: (866) 264-8519
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X ME50635 Florida

Profile Details

NPI number 1316918527
LBN Legal business name Bradshaw, John R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Jun 26th, 2012 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1316918527 NPPES
Florida MEDICAID 046225000

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