NPI Code Details Logo

NPI 1467379552

NPI 1467379552 : ENDOBRAIN HEALTH PLLC : FORT LAUDERDALE, FL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1467379552
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    ENDOBRAIN HEALTH PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/30/2026
-----------------------------------------------------
    Last Update Date     |    06/30/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2630 W BROWARD BLVD STE 203-1023 
-----------------------------------------------------
    City                 |    FORT LAUDERDALE
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33312-1314
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    305-337-1551
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2630 W BROWARD BLVD STE 203-1023 
-----------------------------------------------------
    City                 |    FORT LAUDERDALE
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33312-1314
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    PRESIDENT
-----------------------------------------------------
    Name                 |     ANTHONY  ARIAS BRAVO 
-----------------------------------------------------
    Credential           |    APRN
-----------------------------------------------------
    Telephone            |    646-331-4792
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LP2300X
-----------------------------------------------------
    Taxonomy Name        |    Primary Care Nurse Practitioner
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.