Provider Demographics
NPI:1194449728
Name:BRAVO CONDIT, ALEXIS DEANNA (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:DEANNA
Last Name:BRAVO CONDIT
Suffix:
Gender:
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:DEANNA
Other - Last Name:BRAVO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:7686 N NOB HILL RD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-1843
Practice Address - Country:US
Practice Address - Phone:954-597-0135
Practice Address - Fax:888-640-7837
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11022104363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily