Individual provider Active NPI

Amy G.B. Bravo, PSY.D.

  • Clinical Psychologist
  • Weston, FL
National Provider Identifier
1093827735
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY6418 Issued in FL
Practice address
1725 Main St
Suite 217
Weston, FL 33326-3667
Phone
(954) 385-8884
Fax
(954) 385-6911
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY6418 FL Primary

Addresses

Primary practice location

1725 Main St
Suite 217
Weston, FL 33326-3667

Mailing address

3813 Heron Ridge LN
Weston, FL 33331-3721
Phone (954) 849-6663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110503000736 FL Practitioner - Clinical Psychologist 3870778046 Practice locations: Weston, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1725 Main St
Suite 217
Weston, FL 33326-3670
Phone (954) 385-8884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY6418FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Bravo Clinical Psychologist PA Clinical Current Accepting new patients
Margot C Berros PSYD PL Past Accepting new patients

Locations

1725 Main St
Ste 217
Weston, FL 33326
Phone (954) 385-8884

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093827735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3813 HERON RIDGE LN",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313721",
            "telephone_number": "954-849-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 MAIN ST",
            "address_2": "SUITE 217",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263667",
            "telephone_number": "954-385-8884",
            "fax_number": "954-385-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "AMY",
        "middle_name": "G.B.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

Verify at the official NPI Registry.