BRADEN CLINIC LLC
Osteopathic Medicine at Ave Maria Blvd, Ave Maria, FL

License number
Florida ME104654
Category
Osteopathic Medicine
Type
Anesthesiology
License number
Florida OS12519
Category
Osteopathic Medicine
Type
Emergency Medicine
License number
Florida OS12519
Category
Osteopathic Medicine
Type
Medical Toxicology
License number
Florida OS12519
Category
Osteopathic Medicine
Type
Addiction Medicine
License number
Florida OS13007
Category
Psychiatric
Type
Psychiatry
License number
Florida OS13007
Category
Psychiatric
Type
Child & Adolescent Psychiatry
License number
Florida OS12519
Category
Osteopathic Medicine
Type
General Practice
Owner
Name: BEAU BRADEN DO
Title: MANAGER
Phone: (239) 867-4395
Address
Address
5050 Ave Maria Blvd, Ave Maria, FL 34142
National Provider ID: 1871901157
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about BRADEN CLINIC LLC at bizstanding.com

BRADEN CLINIC, LLC

Ave Maria, FL

Registration:
Jul 30, 2014
Addresses:
5068 Annunciation Cir UNIT #111, Immokalee, FL 34142 (Physical)
5050 Ave Maria Blvd, Immokalee, FL 34142 (Mailing)
5262 Donahue St, Ave Maria, FL 34142
State ID:
L14000119342
Business type:
Florida Limited Liability Company
S:
Beau Braden (Manager), 5202 Milano St, Immokalee, FL 34142 (Physical),Daniel V Dix, 5050 Ave Maria Blvd, Immokalee, FL 34142 (Physical)
Agent:
Braden, Beau,5202 Milano St, Immokalee, FL 34142 (Physical)
EIN:
47-1464216

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