Provider Demographics
NPI:1285257055
Name:BRAVO, KAREN (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BRAVO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:BRAVO RAMIREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5100 COCONUT CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-3913
Mailing Address - Country:US
Mailing Address - Phone:954-281-7700
Mailing Address - Fax:954-715-7603
Practice Address - Street 1:5100 COCONUT CREEK PKWY
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-3913
Practice Address - Country:US
Practice Address - Phone:954-281-7700
Practice Address - Fax:954-715-7603
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2023-05-31
Deactivation Date:2022-01-18
Deactivation Code:
Reactivation Date:2022-03-09
Provider Licenses
StateLicense IDTaxonomies
DCME161668207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine