Doctor Name: | MRS. NICOLA SHEREE BRAVO |
NPI Number: | 1073603445 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | D0045375 |
Business Practice Address: | 1730 Elton Rd Suite 11 Silver Spring, MD - 209031723 |
Business Phone Number: | 3014394303 |
Business Fax Number: | 3014394340 |
Mailing Address: | 1730 Elton Road, Suite 11 SILVER SPRING |
State: | MD |
Postal Code: | 20903 |
Phone Number: | 3014394303 |
Fax Number: | 3014394340 |
NPI Enumeration Date: | 10/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | D0045375 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |