Healthcare Provider Details

I. General information

NPI: 1114939949
Provider Name (Legal Business Name): RICARDO H BRAU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 AVE FD ROOSEVELT SUITE 511
SAN JUAN PR
00918-2103
US

IV. Provider business mailing address

400 FD ROOSEVELT AVENUE SUITE 511
SAN JUAN PR
00918-2132
US

V. Phone/Fax

Practice location:
  • Phone: 787-763-1310
  • Fax: 787-766-7607
Mailing address:
  • Phone: 787-763-1310
  • Fax: 787-766-7607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number5917
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: