Provider Demographics
NPI:1982280400
Name:BRADY, JOSHUA MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:MATTHEW
Last Name:BRADY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 W DR MARTIN LUTHER KING JR BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2301 W DR MARTIN LUTHER KING JR BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6405
Practice Address - Country:US
Practice Address - Phone:813-771-5500
Practice Address - Fax:813-550-0123
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL172044207N00000X
OK39308207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology