Richard S Bragg Md Pa

NPI 1194000554 - Clinic/Center - 261QP2300X

NPI Details
NPI 1194000554
Enumeration Date 10/18/2011
Last Updated 10/18/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name RICHARD RICHARD
Position PRESIDENT
Phone (407) 805-8989
Fax
Practice Location
580 RINEHART RD
SUITE 110
LAKE MARY FL, 32746-1551, US
Phone (407) 805-8989
Fax
Business Location
580 RINEHART RD
SUITE 110
LAKE MARY FL, 32746-1551, US
Phone (407) 805-8989
Fax
Toxanomy
Taxonomy Code 261QP2300X
License State Florida
License Number ME0065139
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According to our database, Richard S Bragg Md Pa NPI is 1194000554, taxonomy code is 261QP2300X and license number is ME0065139, license state is located at Florida. Richard S Bragg Md Pa physically located at 580 Rinehart Rd, Lake Mary FL, 32746-1551. NPI Number 1033115704 has the healthcare provider type.

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1194000554 NPI number is provided on an as is basis without warranty of any kind. 1194000554 is maintained by the National Plan & Provider Enumeration System. The contents of Richard S Bragg Md Pa are for informational purposes only.