# BRAVADO MEDICAL GROUP INC

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

## Provider details

- **NPI number:** 1841919032
- **Authorized official:** RANDY HERFIELD (CEO)
- **Authorized official phone:** (561) 704-6781

## Contact information

- **Practice address:** 1300 NW 17TH AVE STE 160, DELRAY BEACH, FL 33445-2554
- **Practice address phone:** (561) 704-6781
- **Mailing address:** 7601 N FEDERAL HWY STE 245A, BOCA RATON, FL 33487-1672
- **Mailing address phone:** (561) 704-6781
- **Mailing address fax:** (561) 209-0868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/23/2022
- **Last updated:** 08/23/2022