Bravo Care LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

BRAVO CARE LLC

Practice address

8119 Bloomington Ave
Bloomington, MN 55425-1109

Phone

(503) 260-0819

NPI assigned

Jul 25, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mohamed Amin Kedir

Title

Owner

Phone

(503) 260-0819

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1023846466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8119 BLOOMINGTON AVE",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8119 BLOOMINGTON AVE",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251109",
            "telephone_number": "503-260-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVO CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "KEDIR",
        "authorized_official_first_name": "MOHAMED AMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-260-0819"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.