Provider Demographics
NPI:1457738791
Name:DRADEN, RONALD
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:DRADEN
Suffix:
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 1:3596 TAMIAMI TRL STE 205
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-8252
Mailing Address - Country:US
Mailing Address - Phone:941-255-5900
Mailing Address - Fax:941-764-8285
Practice Address - Street 1:3596 TAMIAMI TRL STE 205
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8252
Practice Address - Country:US
Practice Address - Phone:941-255-5900
Practice Address - Fax:941-764-8285
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)