Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME0048949 | FL |
N | 111NI0900X | Internist | ME0048949 | FL |
N | 207RI0200X | Infectious Disease | ME0048949 | FL |
Y | 207RI0200X | Infectious Disease | ME48949 | FL |
NPI | 1023053097 |
---|---|
Provider Name | Bradley S Bender |
First Address | Orlando, FL 32891-8025 |
Second Address | Gainesville, FL 32610-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 19/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
043557100 | (05) | FL |
D57892 | (02) | FL |