Provider Demographics
NPI:1669583118
Name:BRAVO, BELKYS (MD)
Entity type:Individual
Prefix:DR
First Name:BELKYS
Middle Name:
Last Name:BRAVO
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 1:1920 CORAL WAY
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2624
Mailing Address - Country:US
Mailing Address - Phone:305-250-9910
Mailing Address - Fax:305-250-4336
Practice Address - Street 1:1920 CORAL WAY
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-2624
Practice Address - Country:US
Practice Address - Phone:305-250-9910
Practice Address - Fax:305-250-4336
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64617208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002571OtherNEIGHBORHOOD
FL211448OtherAMERIGROUP
FL374129000Medicaid
FLF90000OtherUPIN
FL255635OtherAVMED
FL230659OtherWELLCARE
FL25970OtherBLUE CROSS/BLUE SHIELD