Bravo, Vanessa I

Bravo, Vanessa I is an individual health care provider with primary practice located at 12224 Shady Forest Dr , Riverview FL 33569-5632. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Bravo, Vanessa I can be contacted via phone (813) 671-0807.

Contact Information

Primary practice address
12224 Shady Forest Dr Riverview FL 33569-5632
Phone: (813) 671-0807
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA372 Florida

Profile Details

NPI number 1457400863
LBN Legal business name Bravo, Vanessa I
Credentials MS SLP CCC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Feb 11th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457400863 NPPES
Florida Other 356413 WELLCARE
Florida Other S1374 WELLCARE
Florida MEDICAID 887664900 WELLCARE

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