Provider Demographics
NPI:1144742099
Name:BRAVO, ANET (RT)
Entity Type:Individual
Prefix:
First Name:ANET
Middle Name:
Last Name:BRAVO
Suffix:
Gender:F
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9930 NW 26TH ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1347
Mailing Address - Country:US
Mailing Address - Phone:305-746-9392
Mailing Address - Fax:786-353-2072
Practice Address - Street 1:9930 NW 26TH ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1347
Practice Address - Country:US
Practice Address - Phone:305-746-9392
Practice Address - Fax:786-353-2072
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT16000227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified