Healthcare Provider Details

I. General information

NPI: 1285257055
Provider Name (Legal Business Name): KAREN BRAVO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN BRAVO RAMIREZ

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date: 01/18/2022
Reactivation Date: 03/09/2022

III. Provider practice location address

5100 COCONUT CREEK PKWY
MARGATE FL
33063-3913
US

IV. Provider business mailing address

5100 COCONUT CREEK PKWY
MARGATE FL
33063-3913
US

V. Phone/Fax

Practice location:
  • Phone: 954-281-7700
  • Fax: 954-715-7603
Mailing address:
  • Phone: 954-281-7700
  • Fax: 954-715-7603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME161668
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: