Dr. Bradley Tyler Johnson
Otolaryngologist (ENT Doctor)
133 Benmore Dr Ste 100
Winter Park
, Florida 32792-4111
Dr. Bradley Tyler Johnson
Otolaryngologist (ENT Doctor)
133 Benmore Dr Ste 100
Winter Park
, Florida 32792-4111
(407) 644-3697
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
Languages spoken
- English
Location
First Address
- Dr. Bradley Tyler Johnson
- 133 Benmore Dr Ste 100
- Winter Park, FL
- Zip : 32792-4111
- Fax : (407) 644-3697
- Phone : (407) 644-4883
Second Address
- Dr. Bradley Tyler Johnson
- 133 Benmore Dr Ste 100
- Winter Park, FL
- Zip : 32792-4111
- Fax : (407) 644-3697
- Phone : (407) 644-4883
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME132490 | FL |
National Provider Identifier
| NPI | 1003010596 |
|---|---|
| Provider Name | Dr. Bradley Tyler Johnson |
| First Address | Winter Park, FL 32792-4111 |
| Second Address | Winter Park, FL 32792-4111 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/06/2007 |
| Last Update Date | 27/12/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 022744400 | (05) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.