Provider Demographics
NPI:1942251582
Name:BRAVO, NATASHA (OTR)
Entity Type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:
Last Name:BRAVO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 SW 3RD AVE APT 7E
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2762
Mailing Address - Country:US
Mailing Address - Phone:305-801-7756
Mailing Address - Fax:
Practice Address - Street 1:2950 SW 3RD AVE APT 7E
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-2762
Practice Address - Country:US
Practice Address - Phone:305-801-7756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 6208225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics