Provider Demographics
NPI:1902415318
Name:BRAVE MEDICAL P.C.
Entity Type:Organization
Organization Name:BRAVE MEDICAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-902-6347
Mailing Address - Street 1:1951 NW 7TH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1112
Mailing Address - Country:US
Mailing Address - Phone:305-902-6347
Mailing Address - Fax:727-306-8033
Practice Address - Street 1:73 MARKET ST FL 3
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-7616
Practice Address - Country:US
Practice Address - Phone:305-902-6347
Practice Address - Fax:727-306-8033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-31
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health