Provider Demographics
NPI:1417136623
Name:MUELLER, BRADLEY CLEMENTS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:CLEMENTS
Last Name:MUELLER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10921 CAUSEWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-1997
Mailing Address - Country:US
Mailing Address - Phone:813-952-0102
Mailing Address - Fax:813-952-0109
Practice Address - Street 1:10921 CAUSEWAY BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-1997
Practice Address - Country:US
Practice Address - Phone:813-952-0102
Practice Address - Fax:813-952-0109
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36805183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist