Tara Lynn Bradstreet, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

901 Clark St
Oviedo, FL 32765-7378

Phone

(407) 359-5693

Fax

(407) 792-5693

NPI assigned

Apr 19, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1245973106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 ELLIS FALLON LOOP",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327655967",
            "telephone_number": "919-896-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CLARK ST",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327657378",
            "telephone_number": "407-359-5693",
            "fax_number": "407-792-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSTREET",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Royce Bowen
• Kelsey Boyd, MSW
• Adam Patrick Boylan, D.C.
• Boys Town of Central Florida, Inc.
• Kristen Bozard, MT-BC
• Mary Brady
• Samir Brahmbhatt, RPH
• James Branch, ATC, LAT
• Christine L Braun, M.S.
• Brian L Weinert DDS PA

• Physical Therapy Assistant in Oviedo, FL
• Providers in Oviedo, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.