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General NPI Number Information
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NPI Number | 1386841294
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Entity Type | Individual
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Provider Name | MICHAEL RAFAEL BRAVO-LOUBRIEL DMD
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Gender | Male
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | GRANADA PARK CONDO APT 236 100 MARGINAL STREET
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City | GUAYNABO
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State | PR
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Zip | 00971
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Country | US
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Telephone | 787-272-4062
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Fax |
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Provider Business Mailing Address
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Address Line | LAVILLA GARDEN 26 ROAD 833 APT 1203
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City | GUAYNABO
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State | PR
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Zip | 00971-9009
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Country | US
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Telephone | 787-617-1355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2231
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License Number State | PR
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