NPIMap

Organization Active NPI

Timothy M Bradley MD Pediatric Orthopedic Surgeon PA

  • Pediatric Orthopaedic Surgery Physician
  • Brandon, FL
National Provider Identifier
1508264938
Registry record updated Dec 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
ME87576 Issued in FL
Legal business name
TIMOTHY M BRADLEY MD PEDIATRIC ORTHOPEDIC SURGEON PA
Practice address
602 Vonderburg Dr
Suite 103
Brandon, FL 33511-5900
Phone
(813) 720-8001
NPI assigned
Dec 17, 2014
Last updated
Dec 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2014

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

Authorized official

Name
Timohty M Bradley, M.D.
Title
President
Phone
(813) 833-1028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X ME87576 FL Primary

Addresses

Primary practice location

602 Vonderburg Dr
Suite 103
Brandon, FL 33511-5900

Mailing address

602 Vonderburg Dr
Suite 103
Brandon, FL 33511-5900

National Provider Directory

National Provider Directory

Locations

602 Vonderburg Dr
Ste 103
Brandon, FL 33511
Phone (813) 547-6508

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1418774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418774400000",
    "number": "1508264938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 VONDERBURG DR",
            "address_2": "SUITE 103",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 VONDERBURG DR",
            "address_2": "SUITE 103",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115900",
            "telephone_number": "813-720-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY M BRADLEY MD PEDIATRIC ORTHOPEDIC SURGEON PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-17",
        "last_updated": "2014-12-17",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "TIMOHTY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-833-1028",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "FL",
            "license": "ME87576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; 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.