Provider Demographics
NPI:1174127070
Name:BRADER, APRIL CHRISTINA (DOM)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:CHRISTINA
Last Name:BRADER
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 MAR ST
Mailing Address - Street 2:
Mailing Address - City:ST PETE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33706-2808
Mailing Address - Country:US
Mailing Address - Phone:727-515-8380
Mailing Address - Fax:
Practice Address - Street 1:193 MAR ST
Practice Address - Street 2:
Practice Address - City:ST PETE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33706-2808
Practice Address - Country:US
Practice Address - Phone:727-515-8380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4092171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist