Male or Other

Stephen M. Bravo MD

Diagnostic Radiology Physician in Orlando, FL(View on Map)

Full Name

Stephen M. Bravo MD

NPI Number

1225011281

NPI Type

Individual Provider

Gender

Male

Enumeration Date

11/23/2005

Specialties

(Taxonomies)

Code

2085R0202X

Primary Taxonomy

Yes

Licenses

State

Florida
Maine
New York

License Number

ME83499
MD23939
216768

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 690909
9350 TURKEY LAKE RD

City

Orlando
Orlando

State

FL
FL

Postal Code

32869-0909
32819-7319

Country

US
US

Telephone Number

(407) 363-2772
(407) 363-2772

Identifiers

Identifier

1225011281
267291000
80038

Identifier State

ME
FL
FL

Identifier Issuer

Unknown
Unknown
BC BS OF FLORIDA

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/17/2024

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