Provider Demographics
NPI:1497839815
Name:BETH AND HOWARD BRAVER MD PA
Entity Type:Organization
Organization Name:BETH AND HOWARD BRAVER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ROBYN
Authorized Official - Last Name:BRAVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-466-0663
Mailing Address - Street 1:20950 NE 27TH CT STE 200
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1232
Mailing Address - Country:US
Mailing Address - Phone:305-466-0663
Mailing Address - Fax:305-466-9537
Practice Address - Street 1:20950 NE 27TH CT STE 200
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1232
Practice Address - Country:US
Practice Address - Phone:305-466-0663
Practice Address - Fax:305-466-9537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207R00000X
207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL34699OtherBLUE CROSS BLUE SHIELD
FL34699OtherBLUE CROSS BLUE SHIELD
FLG01847Medicare UPIN
FLK4425Medicare PIN