Individual
ANGELA B BRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8596 ORANGE AVENUE, PENSACOLA, FL 32534
(850) 549-1387
Mailing address
1055 CANDLEWOOD CIRCLE, PENSACOLA, FL 32514-0000
(850) 549-1387
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA-377
AL
363AM0700X
Medical Physician Assistant
Primary
PA9102817
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291980000
—
FL
01
—
59177261
BLUE CROSS BLUE SHIELD
AL
05
—
891009260
—
AL
Enumeration date
12/14/2005
Last updated
06/12/2013
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