Provider Demographics
NPI:1598957318
Name:BRADNER, MICHAEL WARD (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WARD
Last Name:BRADNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3003 W DR MARTIN LUTHER KING JR BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6307
Mailing Address - Country:US
Mailing Address - Phone:813-321-6580
Mailing Address - Fax:813-443-8185
Practice Address - Street 1:3003 W. DR. MARTIN LUTHER KING JR. BLVD.
Practice Address - Street 2:MAB-2ND FLOOR
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-321-6580
Practice Address - Fax:813-443-8135
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME107051208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008498300Medicaid
FL008498300Medicaid