| Practitioners At Home Direct Llc | |
|
1533 4th Ave W Bradenton FL 34205-5949 | |
| (941) 748-8400 | |
| (941) 748-8440 |
| Full Name | Practitioners At Home Direct Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1533 4th Ave W, Bradenton, Florida |
| Authorized Official Name and Position | Anthony Montanaro (MGR) |
| Authorized Official Contact | 9417488400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Practitioners At Home Direct Llc 1533 4th Ave W Bradenton FL 34205-5949 Ph: (941) 748-8400 | Practitioners At Home Direct Llc 1533 4th Ave W Bradenton FL 34205-5949 Ph: (941) 748-8400 |
| NPI Number | 1760730212 |
|---|---|
| Provider Enumeration Date | 08/15/2012 |
| Last Update Date | 10/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760730212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS9181 (Florida) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | ME0067842 (Florida) | Secondary |
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