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General NPI Number Information
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NPI Number | 1376524306
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Entity Type | Organization
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Legal Business Name | BELKYS BRAVO MD PA
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 1920 CORAL WAY
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City | CORAL GABLES
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State | FL
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Zip | 33145-2624
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Country | US
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Telephone | 305-250-9910
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Fax | 305-250-4336
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Provider Business Mailing Address
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Address Line | 1920 CORAL WAY
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City | CORAL GABLES
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State | FL
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Zip | 33145-2624
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Country | US
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Telephone | 305-250-9910
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Fax | 305-250-4336
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | NORA BARANDIARAN
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Credential |
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Telephone | 305-250-9910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME 0064617
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License Number State | FL
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