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Individual
MRS. VANESSA I BRAVO
Active
Individual
MRS. VANESSA I BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS SLP CCC
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA372
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
356413
WELLCARE
FL
05
—
887664900
—
FL
01
—
S1374
BCBS
FL
Enumeration date
01/09/2007
Last updated
02/11/2011
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