Provider Demographics
NPI:1013305051
Name:BRONSON, JAMES III
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BRONSON
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 DAVID WALKER DR
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-6177
Mailing Address - Country:US
Mailing Address - Phone:904-770-2333
Mailing Address - Fax:904-770-2076
Practice Address - Street 1:2904 DAVID WALKER DR
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-6177
Practice Address - Country:US
Practice Address - Phone:904-770-2333
Practice Address - Fax:904-770-2076
Is Sole Proprietor?:No
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist