Active NPI
Jim Bronson, LMT
- Specialist
- Leesburg, FL
National Provider Identifier
1053508747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA24597
- Practice address
- 32815 Radio Rd
Leesburg, FL 34788-3902 - Phone
- (352) 787-8531
- Fax
- (352) 787-3041
- NPI assigned
- Sep 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA24597 | FL | Primary |
Addresses
Primary practice location
32815 Radio Rd
Leesburg, FL 34788-3902
Mailing address
312 W Delaware St
Tavares, FL 32778-2144
Phone (352) 255-9546
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA24597 | FL | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tige Robert Buchanan, D C P a | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190851200000",
"number": "1053508747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 W DELAWARE ST",
"city": "TAVARES",
"state": "FL",
"postal_code": "327782144",
"telephone_number": "352-255-9546",
"fax_number": "352-787-3041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32815 RADIO RD",
"city": "LEESBURG",
"state": "FL",
"postal_code": "347883902",
"telephone_number": "352-787-8531",
"fax_number": "352-787-3041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRONSON",
"first_name": "JIM",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-27",
"last_updated": "2007-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "MA24597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Leesburg, FL
- Brewer Health Services, LLC
- Latoya Brewer
- Bridge to Ability, Inc. (Bridge to Ability Specialized Learning Center)
- Frantz Brignol
- Jeffrey Einar Brink, M.D.
- Brookdale Senior Living Communities, Inc. (Sterling House of Leesburg)
- Janis Brooks, CRNA
- Christina Brown
- Gregory Mark Brown, M.D.
- Stephanie Brown
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.