MEDICARE: DR. JUAN F. BRAVO-FIGUEROA D.D.S.

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	1223G0001X	General Practice Dentistry	2439	PR

General Provider Information

NPI Number	:	1972508992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN F. BRAVO-FIGUEROA D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 20508
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00928-0508
Country	:	US
Telephone Number	:	787-767-7002
Fax Number	:	787-767-7002

Provider Business Practice Location Address
First Line	:	112 CALLE ARZUAGA
Second Line	:	STE 805
City	:	SAN JUAN
State	:	PR
Zip	:	00925-3318
Country	:	US
Telephone Number	:	787-767-7002
Fax Number	:	787-767-7002

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/08/2007

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