Active NPI
Bradley J Daniels, PHD
- Clinical Psychologist
- Orlando, FL
National Provider Identifier
1659627560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY8617
- Practice address
- 100 W Gore St
Orlando, FL 32806-1044 - Phone
- (321) 841-3820
- Fax
- (321) 843-6836
- NPI assigned
- Jul 29, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY8617 | FL | Primary |
Addresses
Primary practice location
100 W Gore St
Orlando, FL 32806-1044
Mailing address
100 W Gore St
Orlando, FL 32806-1044
Phone (321) 841-3820
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY8617 | FL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orlando Health, Inc. | Current | Accepting new patients |
Interoperability endpoints
- bdaniels32011@orlandohealth.medalliesdirect.net
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.
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1184709057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583884800000",
"number": "1659627560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 W GORE ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328061044",
"telephone_number": "321-841-3820",
"fax_number": "321-843-6836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 W GORE ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328061044",
"telephone_number": "321-841-3820",
"fax_number": "321-843-6836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "BRADLEY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-29",
"last_updated": "2020-03-11",
"certification_date": "2020-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY8617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.