Provider Demographics
NPI:1952191397
Name:EMANUEL-THOMPSON, BRIDGGETT JUANITA (CPT)
Entity type:Individual
Prefix:
First Name:BRIDGGETT
Middle Name:JUANITA
Last Name:EMANUEL-THOMPSON
Suffix:
Gender:
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2983 WINDSOR HEIGHTS ST
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-2604
Mailing Address - Country:US
Mailing Address - Phone:252-508-3979
Mailing Address - Fax:
Practice Address - Street 1:2983 WINDSOR HEIGHTS ST
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-2604
Practice Address - Country:US
Practice Address - Phone:252-508-3979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC20-0027R03246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy