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General NPI Number Information
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NPI Number | 1578196721
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Entity Type | Organization
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Legal Business Name | BRAVO HEALTHCARE LLC
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Dates
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Enumeration Date | 02/17/2020
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 3007 BOGOTA AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33026-4509
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Country | US
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Telephone | 872-810-3640
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Fax |
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Provider Business Mailing Address
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Address Line | 8140 MCCORMICK BLVD
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City | SKOKIE
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State | IL
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Zip | 60076-2920
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Country | US
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Telephone | 872-810-3640
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE CYCLE
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Name | ALEKSANDRA SABANAGIC
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Credential |
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Telephone | 872-810-3540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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