| Juan O Bravo Md Pl | |
|
3000 Coral Hills Dr Coral Springs FL 33065-4108 | |
| (863) 398-8362 | |
| (813) 754-7565 |
| Full Name | Juan O Bravo Md Pl |
|---|---|
| Speciality | Preventive Medicine |
| Location | 3000 Coral Hills Dr, Coral Springs, Florida |
| Authorized Official Name and Position | Juan O Bravo (CEO) |
| Authorized Official Contact | 8633988362 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Juan O Bravo Md Pl 170 Fitzgerald Rd Ste 1 Lakeland FL 33813-2633 Ph: (863) 777-2736 | Juan O Bravo Md Pl 3000 Coral Hills Dr Coral Springs FL 33065-4108 Ph: (863) 398-8362 |
| NPI Number | 1336258243 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 03/29/2023 |
| Medicare PECOS PAC ID | 1658386222 |
|---|---|
| Medicare Enrollment ID | O20120703000034 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336258243 | NPI | - | NPPES |
| 271611900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | (* (Not Available)) | Primary |
| Provider Name | Juan O Bravo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558470443 PECOS PAC ID: 7315952918 Enrollment ID: I20060221000130 |
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