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NPI Code Detail

MEDICARE: MS. CRISTINA FAVERO BRAGA PA

MEDICARE: MS. CRISTINA FAVERO BRAGA PA
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 AssistantPA9103922FL

General Provider Information

NPI Number : 1437466950
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CRISTINA FAVERO BRAGA PA
Provider Business Mailing Address
First Line : 121 S. ORANGE AVENUE
Second Line : SUITE 940N
City : ORLANDO
State : FL
Zip : 32801-3234
Country : US
Telephone Number : 321-332-6947
Fax Number : 407-658-9688
Provider Business Practice Location Address
First Line : 810 N. NOWELL STREET
Second Line :
City : ORLANDO
State : FL
Zip : 32808-7539
Country : US
Telephone Number : 407-290-9556
Fax Number : 407-290-9509
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2010
Last Update Date : 08/07/2014

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