MEDICARE: DR. PERCY RENATO BRACAMONTE M.D.

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	207R00000X	Internal Medicine Physician	ME66952	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110131143	OTHER	FL	RAILROAD MEDICARE NUMBER

Other Identifiers

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

General Provider Information

NPI Number	:	1588614952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PERCY RENATO BRACAMONTE M.D.

Provider Business Mailing Address
First Line	:	646 VIRGINIA ST STE 601
Second Line	:
City	:	DUNEDIN
State	:	FL
Zip	:	34698-6612
Country	:	US
Telephone Number	:	727-736-3212
Fax Number	:	813-635-2635

Provider Business Practice Location Address
First Line	:	646 VIRGINIA ST STE 601
Second Line	:
City	:	DUNEDIN
State	:	FL
Zip	:	34698-6612
Country	:	US
Telephone Number	:	727-736-3212
Fax Number	:	813-635-2635

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	05/22/2024

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Directions to “ DR. PERCY RENATO BRACAMONTE M.D.” Practice Location

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