Provider Demographics
NPI:1538692132
Name:BRAVE, ELTILDE
Entity Type:Individual
Prefix:
First Name:ELTILDE
Middle Name:
Last Name:BRAVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-3132
Mailing Address - Country:US
Mailing Address - Phone:786-899-1670
Mailing Address - Fax:
Practice Address - Street 1:614 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-3132
Practice Address - Country:US
Practice Address - Phone:786-899-1670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health