Provider Demographics
NPI:1821534991
Name:PRADO, BRIANA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BRIANA
Middle Name:
Last Name:PRADO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 NW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-4901
Mailing Address - Country:US
Mailing Address - Phone:305-572-2026
Mailing Address - Fax:305-572-2025
Practice Address - Street 1:2015 NW 1ST AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-4901
Practice Address - Country:US
Practice Address - Phone:305-572-2026
Practice Address - Fax:305-572-2025
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9109753363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant