Wade J Bravo, PA
Individual provider Active NPI Physician Assistant · Patrick Afb, FL
NPI 1023085255 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1023085255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA2830 (FL)
- Practice address
- 1381 S Patrick Drive
45TH Medical Group
Patrick Afb, FL 32925 - Phone
- (321) 494-8159
- Fax
- (321) 494-1378
- NPI assigned
- Mar 7, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2830 | FL | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2830 | FL | Yes |
Addresses
Primary practice location
1381 S Patrick Drive
45TH Medical Group
Patrick Afb, FL 32925
Mailing address
1381 S Patrick Drive
45TH Medical Group
Patrick Afb, FL 32925
Phone (321) 494-8159
Other providers in Patrick Afb, FL
- Dauri Zoraida Alvarez
- Kyle Blasser
- Archie Bockhorst
- Spencer Boone
- Elena Gines Botardo
- Thomas James Brown
- Jared Buchanon
- Cara Lee Caddy
- Andy Michael Campos
- Alesia Christen Carrizales
All providers in Patrick Afb, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.