Provider Demographics
NPI:1831150515
Name:BRADY, TED HUGH (DO)
Entity type:Individual
Prefix:DR
First Name:TED
Middle Name:HUGH
Last Name:BRADY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7710 NW 71ST CT
Mailing Address - Street 2:STE 203
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2973
Mailing Address - Country:US
Mailing Address - Phone:954-721-3008
Mailing Address - Fax:954-721-3088
Practice Address - Street 1:7710 NW 71ST CT
Practice Address - Street 2:SUITE 203
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321
Practice Address - Country:US
Practice Address - Phone:954-721-3008
Practice Address - Fax:954-721-3088
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS5247207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80601Medicare ID - Type Unspecified
FLF23683Medicare UPIN