# JUAN O BRAVO MD PL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336258243
- **Authorized official:** JUAN O BRAVO MD, CWS (CEO)
- **Authorized official phone:** (863) 398-8362

## Contact information

- **Practice address:** 3000 CORAL HILLS DR, CORAL SPRINGS, FL 33065-4108
- **Practice address phone:** (863) 398-8362
- **Practice address fax:** (813) 754-7565
- **Mailing address:** 170 FITZGERALD RD STE 1, LAKELAND, FL 33813-2633
- **Mailing address phone:** (863) 777-2736
- **Mailing address fax:** (863) 777-2724

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | NULL | Yes |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 03/29/2023