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NPI Code Detail

MEDICARE: BRAL INTERNATIONAL MEDICAL INSTITUTE LLC

MEDICARE: BRAL INTERNATIONAL MEDICAL INSTITUTE LLC
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
11041C0700XClinical Social Worker
2363LF0000XFamily Nurse Practitioner
3363LP0808XPsychiatric/Mental Health Nurse Practitioner
4106H00000XMarriage & Family Therapist
52084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1619604279
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRAL INTERNATIONAL MEDICAL INSTITUTE LLC
Provider Business Mailing Address
First Line : 1601 E FLAMINGO RD STE 18
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5244
Country : US
Telephone Number : 702-901-9081
Fax Number :
Provider Business Practice Location Address
First Line : 1601 E FLAMINGO RD STE 19
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5244
Country : US
Telephone Number : 702-901-9081
Fax Number :
Authorized Official
Title or Position : OWNER
Name : LUIS ANGEL RODRIGUEZ BAUZA
Credential :
Telephone Number : 702-478-9971
Provider Enumeration Date : 08/03/2022
Last Update Date : 04/08/2026

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Directions to “BRAL INTERNATIONAL MEDICAL INSTITUTE LLC ” Practice Location

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