Provider Demographics
NPI:1114133501
Name:BRADLEY J. ABRAMS DO PA
Entity Type:Organization
Organization Name:BRADLEY J. ABRAMS DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ABRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:941-926-2300
Mailing Address - Street 1:3328 BEE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-7213
Mailing Address - Country:US
Mailing Address - Phone:941-926-2300
Mailing Address - Fax:941-926-8424
Practice Address - Street 1:3328 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-7213
Practice Address - Country:US
Practice Address - Phone:941-926-2300
Practice Address - Fax:941-926-8424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS00007380207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57551OtherBCBS ID
FLK3839Medicare ID - Type Unspecified
FL57551OtherBCBS ID