Individual
JOSEPH JAVIER BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2000
(859) 301-5690
Mailing address
PO BOX 636324, CINCINNATI, OH 45263-6324
(859) 334-5555
(859) 334-5552
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
18650
KY
2086S0129X
Vascular Surgery Physician
Primary
18650
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0356798
—
OH
05
—
64186505
—
KY
Enumeration date
08/19/2005
Last updated
06/30/2010
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