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Organization
JUAN O BRAVO MD PL
Active
Organization
JUAN O BRAVO MD PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN O BRAVO MD, CWS (CEO)
(863) 398-8362
Entity
Organization
Contact information
Practice address
3000 CORAL HILLS DR, CORAL SPRINGS, FL 33065-4108
(863) 398-8362
(813) 754-7565
Mailing address
170 FITZGERALD RD STE 1, LAKELAND, FL 33813-2633
(863) 777-2736
(863) 777-2724
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
—
NULL
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Enumeration date
08/30/2006
Last updated
03/29/2023
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