Fouraker, Bradley D

Fouraker, Bradley D is an individual health care provider with primary practice located at 403 Vonderburg Dr Ste 101, Brandon FL 33511-5982. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Fouraker, Bradley D can be contacted via phone (813) 681-1122.

Contact Information

Primary practice address
403 Vonderburg Dr Ste 101 Brandon FL 33511-5982
Phone: (813) 681-1122
Fax: (813) 684-4924
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME0060284 Florida

Profile Details

NPI number 1467445866
LBN Legal business name Fouraker, Bradley D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated Jul 24th, 2019 - about 5 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 1467445866 NPPES
Florida Other 4414165 AETNA
Florida Other 1674799 AETNA
Florida Other 14958 AETNA
Florida Other 2439747 AETNA
Florida Other 0498749 AETNA
Florida MEDICAID 370277400 AETNA

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