Provider Demographics
NPI:1467426726
Name:BRAMLET, DALE G (MD)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:G
Last Name:BRAMLET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4820 PARK BLVD N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3534
Mailing Address - Country:US
Mailing Address - Phone:727-544-0320
Mailing Address - Fax:727-209-6693
Practice Address - Street 1:4820 PARK BLVD N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3534
Practice Address - Country:US
Practice Address - Phone:727-544-0320
Practice Address - Fax:727-209-6693
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53164207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL07133ZMedicare ID - Type Unspecified
FL049109800Medicaid
FLC64696Medicare UPIN