Provider Demographics
NPI:1144735945
Name:BRADFIELD, JUDITH WATSON (MD)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:WATSON
Last Name:BRADFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:WHITCRAFT
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8024 LINKS WAY
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-3035
Mailing Address - Country:US
Mailing Address - Phone:772-631-8508
Mailing Address - Fax:
Practice Address - Street 1:8024 LINKS WAY
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-3035
Practice Address - Country:US
Practice Address - Phone:772-631-8508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME134278207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology