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DIANE BRAVO

>> Dentist >> Dental Providers

Registrant NPI Number: 1982265708

Individual Registrant:
 DIANE  BRAVO 
Gender: F
Sole Proprietor

Location and contact information for practice:
801 S FEDERAL HWY STE 829  DANIA BEACH, FL 33004-4374 US
Tel: 954-925-2977  Fax: --

Contact information for business:
171 E 4TH ST UNIT 8  HIALEAH, FL 33010-7001 US
Tel: 786-447-2571  Fax: --

Registration Information:
NPI: 1982265708
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
FLDN24228

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
FLORIDA DENTAL LICENSEDN24228FL01




HEALTH CARE JOBS FL - Page 1



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