MEDICARE: DR. BELKYS BRAVO MD

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	208000000X	Pediatrics Physician	ME64617	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	002571	OTHER	FL	NEIGHBORHOOD
2	211448	OTHER	FL	AMERIGROUP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	F90000	OTHER	FL	UPIN
5	255635	OTHER	FL	AVMED
6	230659	OTHER	FL	WELLCARE
7	25970	OTHER	FL	BLUE CROSS/BLUE SHIELD
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669583118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BELKYS BRAVO MD

Provider Business Mailing Address
First Line	:	1920 CORAL WAY
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-2624
Country	:	US
Telephone Number	:	305-250-9910
Fax Number	:	305-250-4336

Provider Business Practice Location Address
First Line	:	1920 CORAL WAY
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-2624
Country	:	US
Telephone Number	:	305-250-9910
Fax Number	:	305-250-4336

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	05/09/2008

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Directions to “ DR. BELKYS BRAVO MD” Practice Location

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