Individual provider · NPI-1

Jennifer Lynn Bradley, O.D.

Optometrist · Titusville, FL

NPI number1487093803
StatusActive
Last updated in NPPESMar 1, 2018

Details

NPI
1487093803
Entity type
Individual (NPI-1)
Name
Jennifer Lynn Bradley
Credential
O.D.
Sex
Female
Sole proprietor
No
Enumeration date
Jun 19, 2013
Last updated
Mar 1, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X OptometristOPC4844FLYes

Other names

  • Jennifer Lynn Cusson (Former Name)

Practice location

338 S Washington Ave.
Titusville, FL 32796-3548

Phone 321-269-2021 · Fax 321-269-2011

Mailing address

338 S Washington Ave.
Titusville, FL 32796-3548

Phone 321-269-2021 · Fax 321-269-2011

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