Provider Demographics
NPI:1295266385
Name:PARRISH, BRADLEY PARKER (DO)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:PARKER
Last Name:PARRISH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 WINDERLEY PL STE 115
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7406
Mailing Address - Country:US
Mailing Address - Phone:407-875-0555
Mailing Address - Fax:407-875-0244
Practice Address - Street 1:7727 LAKE UNDERHILL RD
Practice Address - Street 2:EMERGENCY MEDICINE RESIDENCY
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8224
Practice Address - Country:US
Practice Address - Phone:407-303-6413
Practice Address - Fax:407-303-6414
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-21
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS16965207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty