Provider Demographics
NPI:1487975975
Name:DRURY, BRADLEY ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:ROBERT
Last Name:DRURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13555 KILTIE CT
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-3624
Mailing Address - Country:US
Mailing Address - Phone:502-418-0744
Mailing Address - Fax:
Practice Address - Street 1:7383 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33073-4527
Practice Address - Country:US
Practice Address - Phone:305-395-4411
Practice Address - Fax:305-614-0530
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000054809207Q00000X
FLME140319208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103558900Medicaid