Organization
BRAVO GERIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE BRAVO M.D. (PRESIDENT)
(520) 990-3222
Entity
Organization
Contact information
Practice address
4716 E BURNS ST, TUCSON, AZ 85711-3015
(520) 990-3222
(520) 867-6409
Mailing address
PO BOX 12674, TUCSON, AZ 85732-2674
(520) 990-3222
(520) 867-6409
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
43580
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z145166
MEDICARE
AZ
Enumeration date
04/13/2011
Last updated
11/03/2011
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