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General NPI Number Information
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NPI Number | 1972612091
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Entity Type | Individual
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Provider Name | AMINTA P BRAVO R.PH.
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1201 NW 16TH ST
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City | MIAMI
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State | FL
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Zip | 33125-1624
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Country | US
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Telephone | 305-575-3376
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Fax | 305-575-7503
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Provider Business Mailing Address
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Address Line | 12740 SW 107TH TER
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City | MIAMI
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State | FL
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Zip | 33186-3511
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Country | US
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Telephone | 305-386-6515
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Fax | 305-386-6515
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS23600
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License Number State | FL
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