Provider Demographics
NPI:1457875569
Name:KUCERA, BRADLEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:
Last Name:KUCERA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:886 W SR 436
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3006
Mailing Address - Country:US
Mailing Address - Phone:407-618-0036
Mailing Address - Fax:
Practice Address - Street 1:886 W SR 436
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3006
Practice Address - Country:US
Practice Address - Phone:407-618-0036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56621183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist