| Doctor Name: | WANDA LAVERNE MCGOWAN-BRAYNEN |
| NPI Number: | 1003068552 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | ARNP1750042 |
| Business Practice Address: | 1611 Nw 12th Ave Miami, FL - 331361005 |
| Business Phone Number: | 3055851111 |
| Business Fax Number: | 3059999941 |
| Mailing Address: | 20315 Nw 3rd Ct, MIAMI GARDENS |
| State: | FL |
| Postal Code: | 331692526 |
| Phone Number: | 3056512386 |
| Fax Number: | 3059999941 |
| NPI Enumeration Date: | 10/15/2008 |
| NPI Last Update Date: | 10/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | ARNP1750042 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |