Provider Demographics
NPI:1811991656
Name:BRADEN, JOHN E (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:BRADEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:701 MINORCA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3758
Mailing Address - Country:US
Mailing Address - Phone:786-662-5252
Mailing Address - Fax:888-960-8940
Practice Address - Street 1:6200 SW 73RD ST
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4679
Practice Address - Country:US
Practice Address - Phone:786-662-5252
Practice Address - Fax:888-960-8940
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67031207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL377230600Medicaid
FL26229OtherDR BRADEN'S BCBS FL #
FL26229BMedicare ID - Type UnspecifiedDR BRADEN'S MEDICARE #
FL377230600Medicaid
FL26229OtherDR BRADEN'S BCBS FL #