Individual
FLORESITA B BRAVO EDORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
135 SOUTH PENN AVENUE, HARRISVILLE, WV 26362-0373
(304) 643-4005
(304) 643-4007
Mailing address
PO BOX 373, 135 SOUTH PENN AVENUE, HARRISVILLE, WV 26362-0373
(304) 643-4005
(304) 643-4007
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
12375
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050558000
—
WV
Enumeration date
08/04/2006
Last updated
05/15/2008
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