Provider Demographics
NPI:1164485231
Name:BRACERAS, INES MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:INES
Middle Name:MARIA
Last Name:BRACERAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13400 SW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1833
Mailing Address - Country:US
Mailing Address - Phone:954-900-1466
Mailing Address - Fax:954-900-1553
Practice Address - Street 1:13400 SW 10TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1833
Practice Address - Country:US
Practice Address - Phone:954-900-1466
Practice Address - Fax:954-900-1553
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL90901207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000170107OtherHUMANA
FL294992OtherAVMED
FL9717073OtherCIGNA
FL270634200Medicaid
FL1071901OtherAETNA HMO
FL115933OtherVISTA
FL7699703OtherAETNA NON HMO
FL7699703OtherAETNA NON HMO
FL1071901OtherAETNA HMO