MEDICARE: CLARA PEREZ BRAVO

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
1	183500000X	Pharmacist	PS64292	FL

General Provider Information

NPI Number	:	1437878204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARA PEREZ BRAVO

Provider Business Mailing Address
First Line	:	289 SHORE DR E
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-2623
Country	:	US
Telephone Number	:	787-475-1142
Fax Number	:

Provider Business Practice Location Address
First Line	:	289 SHORE DR E
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-2623
Country	:	US
Telephone Number	:	787-475-1142
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2022
Last Update Date	:	08/25/2022

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Directions to “ CLARA PEREZ BRAVO ” Practice Location

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