Healthcare Provider Details

I. General information

NPI: 1184672123
Provider Name (Legal Business Name): HOWARD MICHAEL BRAVER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 WASHINGTON ST STE 200
HOLLYWOOD FL
33021-8249
US

IV. Provider business mailing address

3700 WASHINGTON ST STE 200
HOLLYWOOD FL
33021-8249
US

V. Phone/Fax

Practice location:
  • Phone: 954-894-3003
  • Fax: 954-894-3323
Mailing address:
  • Phone: 305-466-0663
  • Fax: 305-466-9537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME61028
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME61028
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: