Organization
DORAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILFREDO BRAVO MD (PRESIDENT)
(305) 694-9802
Entity
Organization
Contact information
Practice address
9300 NW 25TH ST, SUITE 106, DORAL, FL 33172-1508
(305) 694-9802
(305) 639-8271
Mailing address
9300 NW 25TH ST, SUITE 106, DORAL, FL 33172-1508
(305) 694-9802
(305) 639-8271
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
ME110036
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME110036
MEDICAL LICENSE
FL
Enumeration date
01/23/2014
Last updated
01/23/2014
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