Active NPI
Opal Bradshaw
- Registered Nurse
- Hollywood, FL
National Provider Identifier
1306279443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN9214224
- Practice address
- 1200 N 35TH Ave
Hollywood, FL 33021-5413 - Phone
- (954) 981-5511
- NPI assigned
- Aug 13, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN9214224 | FL | Primary |
Addresses
Primary practice location
1200 N 35TH Ave
Hollywood, FL 33021-5413
Mailing address
9360 NW 20TH St
Pembroke Pines, FL 33024-3112
Phone (754) 581-2836
Other names 1
- Opal Bradshaw
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 |
|---|---|---|---|
| RN9214224 | FL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376352000000",
"number": "1306279443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9360 NW 20TH ST",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330243112",
"telephone_number": "754-581-2836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N 35TH AVE",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330215413",
"telephone_number": "954-981-5511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "OPAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-13",
"last_updated": "2013-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "FL",
"license": "RN9214224",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "OPAL",
"last_name": "BRADSHAW",
"credential": "RN",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.