MEDICARE: DR. JOHN E BRADEN 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	207P00000X	Emergency Medicine Physician	ME67031	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	26229	OTHER	FL	DR BRADEN'S BCBS FL #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811991656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN E BRADEN MD

Provider Business Mailing Address
First Line	:	701 MINORCA AVE
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-3758
Country	:	US
Telephone Number	:	786-662-5252
Fax Number	:	888-960-8940

Provider Business Practice Location Address
First Line	:	6200 SW 73RD ST
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4679
Country	:	US
Telephone Number	:	786-662-5252
Fax Number	:	888-960-8940

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	10/18/2021

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