| Bradlee Fagerberg, | |
|
9330 Fl-54, Trinity, FL 34655 | |
| (727) 834-4000 | |
| Not Available |
| Full Name | Bradlee Fagerberg |
|---|---|
| Gender | Female |
| Speciality | Anesthesiologist Assistant |
| Location | 9330 Fl-54, Trinity, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609438316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367H00000X | Anesthesiologist Assistant | (* (Not Available)) | Primary |
| Entity Name | Gulf-to-bay Anesthesiology Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720039746 PECOS PAC ID: 5092628156 Enrollment ID: O20031106000250 |
| Entity Name | Ams National Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316330830 PECOS PAC ID: 3870813025 Enrollment ID: O20150529000613 |
| Entity Name | Sunshine State Anesthesia Partners Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437757127 PECOS PAC ID: 8123434792 Enrollment ID: O20210305000003 |
| Entity Name | Northstar Anesthesia Of Florida Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568056166 PECOS PAC ID: 8921522376 Enrollment ID: O20250408001182 |
| Mailing Address | Practice Location Address |
|---|---|
| Bradlee Fagerberg, 14598 Wake Robin Dr, Brooksville, FL 34604-1415 Ph: (352) 817-5776 | Bradlee Fagerberg, 9330 Fl-54, Trinity, FL 34655 Ph: (727) 834-4000 |
Jon-michael Degidio, Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 9330 State Road 54, Trinity, FL 34655 Phone: 727-834-4000 | |
Mr. Justin Lee Drobisch, AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 9330 State Road 54, Trinity, FL 34655 Phone: 727-834-4727 | |
Sebastien Charles, Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 9330 State Road 54, Trinity, FL 34655 Phone: 727-834-4000 | |
Mr. Mark Anthony Leonard, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 9330 State Road 54, Medical Center Of Trinity, Trinity, FL 34655 Phone: 727-834-4000 | |
Taylor Friendt, C-AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 9330 State Road 54, Trinity, FL 34655 Phone: 727-515-4258 | |
Daniel Joe, Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 9330 State Road 54 Ste 340, Trinity, FL 34655 Phone: 727-834-4000 | |
Ms. Victoria Anne Williams, Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 9330 Fl-54, Trinity, FL 34655 Phone: 727-834-4000 |