Provider Demographics
NPI:1184829095
Name:DEAN A BRAMLET M D P A
Entity Type:Organization
Organization Name:DEAN A BRAMLET M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRAMLET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-345-1313
Mailing Address - Street 1:7111 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-1223
Mailing Address - Country:US
Mailing Address - Phone:727-345-1313
Mailing Address - Fax:727-345-0166
Practice Address - Street 1:7111 1ST AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-1223
Practice Address - Country:US
Practice Address - Phone:727-345-1313
Practice Address - Fax:727-345-0166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME038108207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58863Medicare UPIN
K2296AMedicare PIN