Juan Oscar Bravo in Lakeland - Procedural Dermatology
Juan Oscar Bravo - NPI 1558470443
Juan Oscar Bravo is a Procedural Dermatology in Lakeland, Florida. Juan Oscar Bravo practices all healthcare services and medical treatments related to Procedural Dermatology. The NPI Number for Juan Oscar Bravo is 1558470443. The last update date is 2023-03-29.
Juan Oscar Bravo's current location address is 170 Fitzgerald Rd Ste 1, Lakeland, Florida. You can contact this provider via phone number 8637772736 and fax number 8637772724. The mailing address for Juan Oscar Bravo is 170 Fitzgerald Rd Ste 1, Lakeland, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Juan Oscar Bravo |
|---|---|
| Address | 170 Fitzgerald Rd Ste 1, Lakeland, Florida |
| Phone Number | 8637772736 |
| Fax Number | 8637772724 |
| Sole Proprietor | Y |
| Credentials | MD, CWS |
NPI Number Detail
| NPI Number | 1558470443 |
|---|---|
| Provider Enumeration Date | 2006-08-30 |
| Last Updated Date | 2023-03-29 |
Provider Mailing Address Detail
| Address | 170 Fitzgerald Rd Ste 1 |
|---|---|
| City | Lakeland |
| State | Florida (FL) |
| Post Code | 338132633 |
| Phone Number | 8637772736 |
| Fax Number | 8637772724 |
Provider's Primary Taxonomy Detail
| Speciality | Procedural Dermatology |
|---|---|
| Taxonomy | 207Ns0135X |
| Licence No | ME74194 |
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Definition: Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surge |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 271611900 | FL | -- | |
| 44573 | FL | BCBS |
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What is the Juan Oscar Bravo's 1558470443?
The Juan Oscar Bravo's NPI (National Provider Identifier) Number is 1558470443. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Juan Oscar Bravo?
The Juan Oscar Bravo is situated at 170 Fitzgerald Rd Ste 1, in the city of Lakeland, state of FL, with the zip code 338132633.
What is the Juan Oscar Bravo's specialty and taxonomy code?
The Juan Oscar Bravo's specialty is Procedural Dermatology, and the corresponding taxonomy code is 207Ns0135X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1558470443 to Juan Oscar Bravo?
The Centers for Medicare & Medicaid Services originally issued the 1558470443 to Juan Oscar Bravo on 2006-08-30.
As of what date were the details pertaining to Juan Oscar Bravo last refreshed?
The information related to the Juan Oscar Bravo, including its address, specialty, and other relevant details, was last updated on 2023-03-29.