MEDICARE: DR. REYNOLD SYLVESTER BRAITHWAITE 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
1	207VG0400X	Gynecology Physician	ME062140	FL

General Provider Information

NPI Number	:	1457578148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REYNOLD SYLVESTER BRAITHWAITE M.D.

Provider Business Mailing Address
First Line	:	3101 S OCEAN DR STE 2201
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-2801
Country	:	US
Telephone Number	:	954-347-0070
Fax Number	:	305-947-0061

Provider Business Practice Location Address
First Line	:	16876 NE 19TH AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-3108
Country	:	US
Telephone Number	:	305-895-5555
Fax Number	:	305-947-0061

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	12/22/2011

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