KENNETH WAYNE BRADSHAW (NPI# 1225157977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225157977 |
| Entity Type | Individual |
| Full Name | KENNETH WAYNE BRADSHAW |
| Practice Address |
11211 Prosperity Farms Rd B107 Palm Beach Gardens FL 33410-3446 |
| Practice Telephone | 5616308900 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
DN13872 | FL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134197924 | Kenneth Bradshaw | Podiatrist | 1602 N 2nd St, Clinton, MO 64735-1192 | 2006-03-09 |
| 1932182615 | Kenneth Gerard Bradshaw | Family Medicine | 19 Friendship St, Family Physicians of Newport, Suite 130, Newport, RI 02840-2272 | 2005-11-27 |
| Street Address |
11211 PROSPERITY FARMS RD B107 |
| City | PALM BEACH GARDENS |
| State | FL |
| Zip Code | 33410-3446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760489090 | Reliable Diabetic Supply Inc | Durable Medical Equipment & Medical Supplies | 11211 Prosperity Farms Rd, Ste C-210, Palm Beach Gardens, FL 33410-3446 | 2005-07-01 |
| 1043738735 | Kirsten Zerfoss | Physician Assistant | 11211 Prosperity Farms Rd, Suite C-211, Palm Beach Gardens, FL 33410 | 2017-09-02 |
| 1477918969 | Michelle Carrillo-massa, M.d., P.a. | Clinic/Center | 11211 Prosperity Farms Rd, Suite D127, Palm Beach Gardens, FL 33410-3446 | 2015-12-28 |
| 1134592579 | Advance Healing & Wellness Center | Chiropractor | 11211 Prosperity Farms Rd, Suite C208, Palm Beach Gardens, FL 33410-3446 | 2015-11-06 |
| 1376921932 | Upledger Institute Clinic | Acupuncturist | 11211 Prosperity Farms Rd, Suite D223, Palm Beach Gardens, FL 33410-3487 | 2015-05-14 |
| 1326425653 | Justin Roberts | Massage Therapist | 11211 Prosperity Farms Rd, Suite D223, Palm Beach Gardens, FL 33410-3487 | 2015-05-06 |
| 1881092302 | Jorge J Carrillo LLC | Internal Medicine | 11211 Prosperity Farms Rd, Suite D127, Palm Beach Gardens, FL 33410-3446 | 2014-12-16 |
| 1134527765 | Rebecca S. Flowers, Pa | Clinic/Center | 11211 Prosperity Farms Rd, Suite D223, Palm Beach Gardens, FL 33410-3446 | 2014-12-13 |
| 1225449242 | Morgan K Panora | Clinical Neuropsychologist | 11211 Prosperity Farms Rd, Suite C303, Palm Beach Gardens, FL 33410-3446 | 2014-05-13 |
| 1497170666 | Alessandra Colon | Chiropractor | 11211 Prosperity Farms Rd, Ste C208, Palm Beach Gardens, FL 33410-3446 | 2014-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811501026 | Vicky Pauline Salazar | Registered Nurse | 11501 N Military Trail, Palm Beach Gardens, FL 33410 | 2020-09-04 |
| 1417596388 | Chavon E Mayer | Doula | 149 Winter Park Lane, West Palm Beach, FL 33410 | 2019-12-24 |
| 1639711617 | Diamond Physical Therapy, LLC | Physical Therapist | 4025 Johnson Dairy Road, Palm Beach Gardens, FL 33410 | 2019-10-11 |
| 1689151714 | Caroline Devries Hesterman | Occupational Therapist | 9840 Alternate A1a Ste 402, Palm Beach Gardens, FL 33410 | 2018-07-21 |
| 1366937088 | Krystal Maya Khemkaran | Behavior Technician | 2979 Pga Blvd # 200, Palm Beach Gardens, FL 33410 | 2018-06-25 |
| 1548762552 | Arsenia Pomperada Sabusap | Nurse Practitioner | Grace Medical Center of Florida, 4212 Northlake Blvd., Palm Beach Gardens, FL 33410 | 2018-03-06 |
| 1538668199 | Alan Seidenfeld | Dentist | 7305 N Military Trl 3a-200, Riviera Beach, FL 33410 | 2018-02-08 |
| 1407361454 | Nuvista Living At Jupiter, LLC | Skilled Nursing Facility | 338 Pioneer Road, Jupiter, FL 33410 | 2017-12-12 |
| 1083125728 | Tom Long Biddle-xing | Nurse Practitioner | 3345 Burns Rd Ste 206, Palm Beach Gardens, FL 33410 | 2017-10-20 |
| 1801315189 | Kasie Sidman | Physical Therapist | 3929 Bluebell St, Palm Beach Gardens, FL 33410 | 2017-09-18 |
| Find all providers in zip 33410 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548302128 | Robert I Berlin | Dentist | 725 Pinehurst Way, Palm Beach Gardens, FL 33418-8499 | 2007-02-12 |
| 1003824863 | Michael Richard Wolov | Dentist | 81 Saint James Ct, Palm Beach Gardens, FL 33418-4020 | 2006-08-04 |
| 1740431980 | Palm Beach Endodontics, P.a. | Dentist | 11211 Prosperity Farms Rd, Suite B107, Palm Beach Gardens, FL 33410-3446 | 2008-10-07 |
| 1548476203 | Jussara M Morsani | Dentist | 11380 Prosperity Farms Rd, Suite 214, Palm Beach Gardens, FL 33410-3474 | 2007-05-16 |
| 1073633707 | Stephen Thomas Galla | Dentist | 11211 Prosperity Farms Rd, Suite B107, Palm Beach Gardens, FL 33410-3446 | 2007-03-29 |
| 1699894303 | Charlyn Rappa Bradshaw | Dentist | 11211 Prosperity Farms Rd, Suite B107, Palm Beach Gardens, FL 33410-3446 | 2007-03-27 |
| 1891823514 | Gary L Laukhuf | Dentist | 11380 Prosperity Farms Rd, 214, Palm Beach Gardens, FL 33410-3474 | 2007-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608736 | Mid-florida Endodontics - Winter Garden Pa | Dentist | 15815 Shaddock Drive, Unit-3, Winter Garden, FL 34787 | 2020-10-30 |
| 1154935799 | Orbit Dental Management Pa | Dentist | 1453 Nw Saint Lucie West Blvd, Port St Lucie, FL 34986-1968 | 2020-09-01 |
| 1790397370 | Bruce D. Schulman, Dds Pa | Dentist | 10150 Hagen Ranch Rd Ste 200, Boynton Beach, FL 33437-3776 | 2020-08-17 |
| 1770117525 | Volusia Endodontics Pa | Dentist | 2751 Enterprise Rd Ste 211, Orange City, FL 32763-8262 | 2020-03-02 |
| 1417587130 | Advanced Endodontics of Winter Park, Pa | Dentist | 400 W Morse Blvd Ste 102, Winter Park, FL 32789-4259 | 2020-01-22 |
| 1699326603 | North Central Florida Endodontics,pllc | Dentist | 48 Se 16th Ave, Ocala, FL 34471-2521 | 2019-09-23 |
| 1396395919 | Stephen L. Goldfaden, Dds,pa | Dentist | 1905 Nw 13th St Ste 2, Gainesville, FL 32609-3414 | 2019-09-16 |
| 1649820630 | Ponte Vedra Endodontics | Dentist | 822 A1a North, Ste 314, Ponte Vedra Beach, FL 32082 | 2019-09-12 |
| 1437707197 | John Zachary Reynolds | Dentist | 3180 Redeemer Way, New Port Richey, FL 34655-4245 | 2019-08-27 |
| 1497307987 | Bradley Sleeth | Dentist | 942 Goldridge Ct, Orange Park, FL 32065-6259 | 2019-07-15 |
| Find all providers with the same taxonomy | ||||
| City | PALM BEACH GARDENS |
| Zip Code | 33410 |
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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.