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NPI Code Detail

MEDICARE: DR. WILFREDO EDDY BRAVO M.D.

MEDICARE: DR. WILFREDO EDDY BRAVO M.D.
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
1207RE0101XEndocrinology, Diabetes & Metabolism PhysicianME110036FL
2207R00000XInternal Medicine PhysicianME110036FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457544702
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILFREDO EDDY BRAVO M.D.
Provider Business Mailing Address
First Line : 101415 OVERSEAS HWY
Second Line :
City : KEY LARGO
State : FL
Zip : 33037-4504
Country : US
Telephone Number : 954-368-4786
Fax Number : 954-368-4101
Provider Business Practice Location Address
First Line : 4800 W FLAGLER ST STE 215
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-1402
Country : US
Telephone Number : 954-368-4786
Fax Number : 954-368-4101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2007
Last Update Date : 09/17/2025

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