Provider Demographics
NPI:1659510477
Name:OSCAR R. BRAVO-CAMPA MD PA
Entity Type:Organization
Organization Name:OSCAR R. BRAVO-CAMPA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PD
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRAVO-CAMPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-261-8001
Mailing Address - Street 1:7500 SW 8TH ST
Mailing Address - Street 2:PH-2
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4400
Mailing Address - Country:US
Mailing Address - Phone:305-261-8001
Mailing Address - Fax:305-261-4485
Practice Address - Street 1:7500 SW 8TH ST
Practice Address - Street 2:PH-2
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4400
Practice Address - Country:US
Practice Address - Phone:305-261-8001
Practice Address - Fax:305-261-4485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME41182208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty