Provider Demographics
NPI:1407669849
Name:BRAGG, MARIA I (APRN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:I
Last Name:BRAGG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17100 N BAY RD APT 1807
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3460
Mailing Address - Country:US
Mailing Address - Phone:305-298-5426
Mailing Address - Fax:
Practice Address - Street 1:17100 N BAY RD APT 1807
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3460
Practice Address - Country:US
Practice Address - Phone:305-298-5426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11030374363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily