Bradley B Kreisher

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

31997 Issued in FL

Practice address

4400 N Highway 19a
Mount Dora, FL 32757-2032

Phone

(352) 800-4231

NPI assigned

Jun 7, 2022

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1619606423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10007 LENOX ST",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347119114",
            "telephone_number": "321-460-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 N HIGHWAY 19A",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572032",
            "telephone_number": "352-800-4231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREISHER",
        "first_name": "BRADLEY",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "31997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jocelyn N Kiss
• Jeffrey Robert Knittel, D.D.S., M.D.
• Mary K Kolacsky
• Kailey Koontz, PA-C
• Josh Kramer
• Kenneth David Kronhaus, MD
• Caroline Elizabeth Krueger, D.M.D.
• Karen S Kyle, OTR/L
• Dukens Labaze, M.D.
• Stephanie M Lacquaniti, D.M.D.

• Physical Therapy Assistant in Mount Dora, FL
• Providers in Mount Dora, 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 Jun 7, 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.