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NPI Code Detail

MEDICARE: DR. JASMINE MARIE BRAVO-BEAUMONT OD

MEDICARE: DR. JASMINE MARIE BRAVO-BEAUMONT OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPC005736FL
2152W00000XOptometristOEG003503PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427513167
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASMINE MARIE BRAVO-BEAUMONT OD
Provider Business Mailing Address
First Line : 160 BOSTON AVE
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32701-4798
Country : US
Telephone Number : 407-775-7654
Fax Number : 407-834-6082
Provider Business Practice Location Address
First Line : 7524 N HIMES AVE
Second Line :
City : TAMPA
State : FL
Zip : 33614-3205
Country : US
Telephone Number : 813-931-0500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2019
Last Update Date : 03/06/2026

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