Healthcare Provider Details

I. General information

NPI: 1356909881
Provider Name (Legal Business Name): RAQUEL MARIA BRAVO-CLOUZET MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 E GRANT RD
TUCSON AZ
85712-2805
US

IV. Provider business mailing address

6890 E SUNRISE DR # 120-213
TUCSON AZ
85750-0738
US

V. Phone/Fax

Practice location:
  • Phone: 520-324-2594
  • Fax:
Mailing address:
  • Phone: 520-258-9798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number67497
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number67497
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: