| Bravo Geriatrics | |
|
4716 E Burns St Tucson AZ 85711-3015 | |
| (520) 990-3222 | |
| (520) 867-6409 |
| Full Name | Bravo Geriatrics |
|---|---|
| Speciality | Internal Medicine |
| Location | 4716 E Burns St, Tucson, Arizona |
| Authorized Official Name and Position | Stephanie Bravo (PRESIDENT) |
| Authorized Official Contact | 5209903222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bravo Geriatrics Po Box 12674 Tucson AZ 85732-2674 Ph: (520) 990-3222 | Bravo Geriatrics 4716 E Burns St Tucson AZ 85711-3015 Ph: (520) 990-3222 |
| NPI Number | 1528358322 |
|---|---|
| Provider Enumeration Date | 04/13/2011 |
| Last Update Date | 11/03/2011 |
| Medicare PECOS PAC ID | 7810174679 |
|---|---|
| Medicare Enrollment ID | O20110602000607 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528358322 | NPI | - | NPPES |
| Z145166 | Other | AZ | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 43580 (Arizona) | Primary |
| Provider Name | Stephanie C Bravo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194917716 PECOS PAC ID: 2668659426 Enrollment ID: I20110602000578 |
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