Individual
KAREN R BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 505-0455
Mailing address
15500 SW 200TH ST, MIAMI, FL 33187-3000
(305) 505-0455
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25MA09182500
NJ
2085R0202X
Diagnostic Radiology Physician
Primary
ME80710
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0305651
—
NJ
05
—
259354800
—
FL
01
—
P01097924
RR MEDICARE
NJ
01
—
P01097933
RR MEDICARE
NJ
01
—
P01097970
RR MEDICARE
NJ
Enumeration date
11/30/2006
Last updated
06/23/2017
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