Healthcare Provider Details

I. General information

NPI: 1588584775
Provider Name (Legal Business Name): NANCY BRACHE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10397 N KENDALL DR APT W1
MIAMI FL
33176-1624
US

IV. Provider business mailing address

10397 N KENDALL DR APT W1
MIAMI FL
33176-1624
US

V. Phone/Fax

Practice location:
  • Phone: 786-470-0244
  • Fax:
Mailing address:
  • Phone: 786-470-0244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI5929
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberCI1081
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA66239
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: