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NPI Code Detail

MEDICARE: DR. ALFREDO A BRAVO COLON MD

MEDICARE:  DR. ALFREDO A BRAVO COLON  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician9336PR

General Provider Information

NPI Number : 1164482220
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALFREDO A BRAVO COLON MD
Provider Business Mailing Address
First Line : 609 AVE TITO CASTRO
Second Line : PMB 222 SUITE 102
City : PONCE
State : PR
Zip : 00716-0200
Country : US
Telephone Number : 787-844-6230
Fax Number : 787-848-4737
Provider Business Practice Location Address
First Line : 2907 AVE EMILIO FAGOT
Second Line :
City : PONCE
State : PR
Zip : 00716-3613
Country : US
Telephone Number : 787-844-6230
Fax Number : 787-848-4737
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 11/10/2011

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