Provider Demographics
NPI:1023037504
Name:DRAPER, BRYANT (MD)
Entity Type:Individual
Prefix:
First Name:BRYANT
Middle Name:
Last Name:DRAPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 LAKE COVENTRY CT
Mailing Address - Street 2:
Mailing Address - City:GOTHA
Mailing Address - State:FL
Mailing Address - Zip Code:34734-5206
Mailing Address - Country:US
Mailing Address - Phone:407-403-4901
Mailing Address - Fax:407-296-7318
Practice Address - Street 1:4413 US HIGHWAY 331 S
Practice Address - Street 2:
Practice Address - City:DEFUNIAK SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32435-6307
Practice Address - Country:US
Practice Address - Phone:850-951-4500
Practice Address - Fax:850-951-4586
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95992207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine