Provider Demographics
NPI:1962441329
Name:TOWBIN, BRADLEY A (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:A
Last Name:TOWBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 740177
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33474-0177
Mailing Address - Country:US
Mailing Address - Phone:561-738-5772
Mailing Address - Fax:561-738-0096
Practice Address - Street 1:7270 W BOYNTON BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3802
Practice Address - Country:US
Practice Address - Phone:561-738-5772
Practice Address - Fax:561-738-0096
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65968207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263124500Medicaid
FLE48622Medicare UPIN
FL263124500Medicaid