BRADENTON SURGICAL GROUP PA (NPI# 1164418182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164418182 |
| Entity Type | Organization |
| Organization Name | BRADENTON SURGICAL GROUP PA |
| Practice Address |
200 3rd Ave W Ste 110 Bradenton FL 34205-8626 |
| Mailing Address |
200 3rd Ave W Suite 110 Bradenton FL 34205-8626 |
| Practice Telephone | 9417442700 |
| Practice Fax Number | 9417442705 |
| Mailing Telephone | 9417442700 |
| Mailing Fax Number | 9417442705 |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | GARY M BUNCH (OWNER) |
| Authorized Official Telephone | 9417442700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
========= | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAIL ROAD MEDICARE | CK2566 | 01 |
| FL | BCBS | 94850 | 01 |
| FL | AETNA | 7385373 | 01 |
| Street Address |
200 3RD AVE W STE 110 |
| City | BRADENTON |
| State | FL |
| Zip Code | 34205-8626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518950187 | Edward Herrman | Urology | 200 3rd Ave W, Suite 210, Bradenton, FL 34205-8626 | 2005-08-29 |
| 1831557966 | David Deering | Nurse Practitioner | 200 3rd Ave W, Suite 210, Bradenton, FL 34205-8626 | 2016-02-03 |
| 1801157474 | 21st Century Oncology LLC | Durable Medical Equipment & Medical Supplies | 200 3rd Ave W, Suite 210, Bradenton, FL 34205-8626 | 2012-05-31 |
| 1780957696 | Genesiscare Usa of Florida LLC | Urology | 200 3rd Ave W, Suite 210, Bradenton, FL 34205-8626 | 2012-02-23 |
| 1841507738 | Florida Medical Specialists LLC | Internal Medicine | 200 3rd Ave W, Suite 100, Bradenton, FL 34205-8626 | 2010-09-13 |
| 1326213091 | Janine Rae Zaccagnino | Nurse Practitioner | 200 3rd Ave W, Suite 100, Bradenton, FL 34205-8626 | 2008-04-24 |
| 1487869400 | Sean Alexander Castellucci | Urology | 200 3rd Ave W, Suite 210, Bradenton, FL 34205-8626 | 2007-05-12 |
| 1295869535 | Catherine Mcging | Nurse Practitioner | 200 3rd Ave W, Suite 210, Bradenton, FL 34205-8626 | 2007-03-16 |
| 1427135714 | Neurospinal Associates Pa | Neurological Surgery | 200 3rd Ave W, Suite 200, Bradenton, FL 34205-8626 | 2006-11-01 |
| 1669488839 | Manatee Urology Pa | Urology | 200 3rd Ave W, Suite 210, Bradenton, FL 34205 | 2006-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649811506 | Fenix Drug Store, LLC | Pharmacy | 527 13th St W, Bradenton, FL 34205 | 2019-10-02 |
| 1326534702 | Elaine Benitez Vazquez | Developmental Therapist | 3800 Lake Bayshore Dr Apt 513, Bradenton, FL 34205 | 2018-07-09 |
| 1437519402 | Kenneth G Bannister | Massage Therapist | 302 26th Avenue East, Apt 101, Bradenton, FL 34205 | 2016-03-03 |
| 1780028415 | Nic 4 Summerfield Leasing LLC | Assisted Living Facility | 3409 26th St. W., Bradenton, FL 34205 | 2013-04-24 |
| 1275803017 | Jennifer Geanne Washington | Massage Therapist | 1901 9th Ave W, Bradenton, FL 34205 | 2012-01-11 |
| 1629352745 | Susan K Stone | Acupuncturist | 2620 Manatee Avenue W., Suite C, Bradenton, FL 34205 | 2011-10-07 |
| 1588957609 | Palma Sola Therapies LLC | Physical Medicine & Rehabilitation | 515 36th St., Suite D, Bradenton, FL 34205 | 2011-05-23 |
| 1023254836 | Halle Kranz | Counselor | 239 301 Blvd W, Bradenton, FL 34205 | 2008-12-29 |
| 1235389537 | Aisha Mohsin Malik | Psychiatry & Neurology | 200 3rd Avenue West, Suite 110, Bradenton, FL 34205 | 2008-09-23 |
| 1689895146 | Brenda Marie Wilson | Counselor | Manatee Service Center, 600 301 Blvd - Suite 144, Bradenton, FL 34205 | 2007-05-01 |
| Find all providers in zip 34205 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114336021 | Florida Vein Center, Inc | Surgery | 6050 53rd Ave E Unit A, Bradenton, FL 34203-9700 | 2014-08-05 |
| 1306104336 | The Vascular Group of Bradenton, P.l. | Surgery | 4502 Cortez Rd W, 2nd Floor, Bradenton, FL 34210-3143 | 2012-04-27 |
| 1740217116 | Woodrow W Yeaney IIi | Surgery | 4502 Cortez Rd W Fl 2, Bradenton, FL 34210-3143 | 2006-06-28 |
| 1669997466 | Venas Vascular Specialists Pllc | Surgery | 5860 Ranch Lake Blvd Ste 200, Bradenton, FL 34202-3719 | 2017-08-14 |
| 1790953933 | Vivian Marie Torres | Surgery | 5860 Ranch Lake Blvd Ste 200, Bradenton, FL 34202-3719 | 2008-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104394857 | George Scott Hall Sr. | Surgery | 9 Marsh Creek Rd, Fernandina Beach, FL 32034-6413 | 2018-11-09 |
| 1316413115 | Fox Vascular Experts, LLC | Surgery | 2699 Stirling Rd Ste A301302, Fort Lauderdale, FL 33312-6517 | 2018-10-18 |
| 1114417508 | Vascular Center of Naples Inc. | Surgery | 5490 Bryson Dr Ste 201, Naples, FL 34109 | 2018-05-11 |
| 1598267593 | Joseph D Stillword, Md | Surgery | 800 Zeagler Dr Ste 320, Palatka, FL 32177-3827 | 2018-03-06 |
| 1386157006 | Beatriz Lam | Surgery | 2001 West 68 St, Cvicu, Hialeah, FL 33016 | 2017-11-16 |
| 1811421092 | Sunrise Vascular Center | Surgery | 8555 Nw 165th Ter, Miami Lakes, FL 33016-6138 | 2017-04-14 |
| 1962891838 | Global Trauma Systems, Inc | Surgery | 126 Se Mira Lavella, Port Saint Lucie, FL 34984-6615 | 2015-01-15 |
| 1184013450 | Vas-q-lar, Inc | Surgery | 6187 Nw 167th St, Suite H13, Hialeah, FL 33015-4340 | 2015-01-09 |
| 1396147138 | Usa Vein Clinics of Miami, LLC | Surgery | 1711 E Hallandale Beach Blvd Ste B, Hallandale Beach, FL 33009-4621 | 2014-09-24 |
| 1528484516 | Rolando Sanchez | Surgery | 4039 W Kennedy Blvd, Tampa, FL 33609-2751 | 2014-03-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.