Individual
DR. CARIDAD BRAVO-FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15262 N. 75TH AVENUE,, SUITE 400 PAIN SOLUTION CENTER, LLC, PEORIA, AZ 85381-4762
(623) 486-1510
Mailing address
9200 W WISCONSIN AVE, HOSPITAL BASED @ FROEDTERT HOSP., MILWAUKEE, WI 53226-3522
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
45254
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004806261H
HUMANA
—
05
—
31543500
—
WI
Enumeration date
05/12/2006
Last updated
03/21/2012
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