Provider Demographics
NPI:1447471230
Name:BRANIC, GLADYS (MD)
Entity type:Individual
Prefix:DR
First Name:GLADYS
Middle Name:
Last Name:BRANIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 6TH AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-1928
Mailing Address - Country:US
Mailing Address - Phone:941-748-0747
Mailing Address - Fax:941-747-7347
Practice Address - Street 1:410 6TH AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1928
Practice Address - Country:US
Practice Address - Phone:941-748-0747
Practice Address - Fax:941-747-7347
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME556762083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine