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NPI Code Detail

MEDICARE: LAQUESHA N BRAYNEN

MEDICARE:   LAQUESHA N BRAYNEN
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
1363A00000XPhysician Assistant9120381FL

General Provider Information

NPI Number : 1184441719
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAQUESHA N BRAYNEN
Provider Business Mailing Address
First Line : 85 NW 165TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33169-6009
Country : US
Telephone Number : 786-454-0063
Fax Number :
Provider Business Practice Location Address
First Line : 5818 S DIXIE HWY
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33405-3608
Country : US
Telephone Number : 561-429-4779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2024
Last Update Date : 08/02/2025

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Directions to “ LAQUESHA N BRAYNEN ” Practice Location

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