Provider Demographics
NPI:1942283684
Name:MCCANTS, BRADLEY (MPT)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:
Last Name:MCCANTS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 NW 60TH ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-6026
Mailing Address - Country:US
Mailing Address - Phone:352-332-3481
Mailing Address - Fax:
Practice Address - Street 1:618 NW 60TH ST
Practice Address - Street 2:SUITE I
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-6026
Practice Address - Country:US
Practice Address - Phone:352-332-3481
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20235225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U4513ZMedicare ID - Type Unspecified