Provider Demographics
NPI:1134495021
Name:BRADLEY, TERRENCE J (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:J
Last Name:BRADLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1475 NW 12TH AVE
Mailing Address - Street 2:SUITE 3300 D8-4
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1002
Mailing Address - Country:US
Mailing Address - Phone:305-212-0436
Mailing Address - Fax:305-545-8933
Practice Address - Street 1:1475 NW 12TH AVE
Practice Address - Street 2:SUITE 3300 D8-4
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-212-0436
Practice Address - Fax:305-545-8933
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY272574207R00000X
FLME137418207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine