Michael Rafael Bravo-Loubriel, DMD
Individual provider Active NPI Dentist · Guaynabo, PR
NPI 1386841294 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1386841294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2231 (PR)
- Practice address
- Granada Park Condo Apt 236
100 Marginal Street
Guaynabo, PR 00971 - Phone
- (787) 272-4062
- NPI assigned
- Jul 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160418002148 | PR | Order and Referring Only - Oral Surgery |
2769780105 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2231 | PR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2231 | PR | Yes |
Addresses
Primary practice location
Granada Park Condo Apt 236
100 Marginal Street
Guaynabo, PR 00971
Mailing address
Lavilla Garden
26 Road 833 Apt 1203
Guaynabo, PR 00971-9009
Phone (787) 617-1355
Other providers in Guaynabo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.