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General NPI Number Information
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NPI Number | 1538436431
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Entity Type | Organization
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Legal Business Name | BRAVO DENTAL P.A.
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Dates
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Enumeration Date | 11/19/2011
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Last Update Date | 07/14/2016
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Provider Practice Location Address
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Address Line | 909 N MIAMI BEACH BLVD SUITE 501
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-3712
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Country | US
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Telephone | 305-945-9333
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Fax |
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Provider Business Mailing Address
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Address Line | 20904 LEEWARD CT # 221
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City | AVENTURA
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State | FL
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Zip | 33180-3873
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Country | US
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Telephone | 305-496-3856
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA ALEJANDRA YANEZ BRAVO
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Credential | DDS
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Telephone | 305-496-3856
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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 | DN19497
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License Number State | FL
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