Provider Demographics
NPI:1609020841
Name:BRUNO, CARMEN SIVILA (MD)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:SIVILA
Last Name:BRUNO
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 1:8777 COLLINS AVE APT 310
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE
Mailing Address - State:FL
Mailing Address - Zip Code:33154-3408
Mailing Address - Country:US
Mailing Address - Phone:305-864-5381
Mailing Address - Fax:
Practice Address - Street 1:955 NW 3RD ST
Practice Address - Street 2:105
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33128-1274
Practice Address - Country:US
Practice Address - Phone:305-324-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 1003672084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry