Bradshaw, Jonathan James

Bradshaw, Jonathan James is an individual health care provider with primary practice located at 4500 San Pablo Rd S , Jacksonville FL 32224-1865. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Bradshaw, Jonathan James can be contacted via phone (904) 953-2000.

Contact Information

Primary practice address
4500 San Pablo Rd S Jacksonville FL 32224-1865
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA 9103821 Florida

Profile Details

NPI number 1992765168
LBN Legal business name Bradshaw, Jonathan James
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Mar 11th, 2009 - about 15 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 1992765168 NPPES
Florida MEDICAID 292826400

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