Middaugh, Bradley David

Middaugh, Bradley David is an sole proprietor health care provider with primary practice located at 1537 Brantley Rd Unit A2, Fort Myers FL 33907-3923. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Middaugh, Bradley David can be contacted via phone (239) 481-7799.

Contact Information

Primary practice address
1537 Brantley Rd Unit A2 Fort Myers FL 33907-3923
Phone: (239) 481-7799
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC0002377 Florida

Profile Details

NPI number 1679575187
LBN Legal business name Middaugh, Bradley David
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 15th, 2005
Last updated Feb 24th, 2022 - about 2 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 1679575187 NPPES
Florida Other 19695W MEDICARE PTAN
Florida MEDICAID 078638100 MEDICARE PTAN

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