Bradley W Orville, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9110580 Issued in FL

Practice address

3340 Tamiami TRL
Port Charlotte, FL 33952-8088

Phone

(941) 764-5858

Fax

(941) 764-1657

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  Medicare reassignment NPD
• Mercy Health Physicians Youngstown Specialty Care LLC

  • Surgery Physician
  • Youngstown, OH
  • NPI 1649892225

  Physician Assistant

  Medicare reassignment NPD
• Mercy Health Physicians Youngstown, LLC

  • Family Medicine Physician
  • Youngstown, OH
  • NPI 1154636066

  Physician Assistant

  Medicare reassignment NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702
  NPD
• Mercy Health Physicians Youngstown Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Boardman, OH
  • NPI 1386316107
  NPD

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1922088616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528088",
            "telephone_number": "941-764-5858",
            "fax_number": "941-764-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORVILLE",
        "first_name": "BRADLEY",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002022",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise E Orazi, DC
• Dominica Ngozi Orisakwe
• Orthotic & Prosthetic Centers, Inc.
• Karla Ortiz Silot
• Franky Ortiz
• Matthew Osborne, PA-C
• Katherine Osorio Londono, RBT
• Alia Osseiran, DMD
• Ashley Ottey
• Jennifer Ouellet, LMHC

• Physician Assistant in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.