Wallrath, Bradley J

Wallrath, Bradley J is an individual health care provider with primary practice located at 5430 Military Trl Ste 64 , Jupiter FL 33458-2873. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Wallrath, Bradley J can be contacted via phone (561) 263-7010.

Contact Information

Primary practice address
5430 Military Trl Ste 64 Jupiter FL 33458-2873
Phone: (561) 263-7010
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9107050 Florida
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA9107050 Florida

Profile Details

NPI number 1720329485
LBN Legal business name Wallrath, Bradley J
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2013
Last updated Mar 22nd, 2024 - about 6 months 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 1720329485 NPPES
Georgia MEDICAID 003134530A
Georgia MEDICAID 008416700

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