Small, Michael Bradley
Small, Michael Bradley is an individual health care provider with primary practice located at 4211 Van Dyke Rd #200, Lutz FL 33558-8005. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Small, Michael Bradley can be contacted via phone (813) 264-6490.Contact Information
Primary practice address
4211 Van Dyke Rd #200
Lutz FL 33558-8005
Phone: (813) 264-6490
Fax: (813) 443-8143
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | ME104627 | Florida |
Profile Details
| NPI number | 1811182199 |
|---|---|
| LBN Legal business name | Small, Michael Bradley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 11th, 2007 |
| Last updated | Mar 22nd, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811182199 | NPPES |
| Florida | MEDICAID | 003017701 |
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