Individual provider Active NPI

Angela Bravo Matos, ARNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1396213005
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11000021 Issued in FL
Practice address
1460 E 8TH CT
Hialeah, FL 33010-3326
Phone
(786) 536-4964
NPI assigned
Nov 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11000021 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11000021 FL Primary

Addresses

Primary practice location

1460 E 8TH CT
Hialeah, FL 33010-3326

Mailing address

1460 E 8TH CT
Hialeah, FL 33010-3326

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250228002157 FL Practitioner - Nurse Practitioner 2466972849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Doral, FL 33166
Phone (786) 442-1869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11000021FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bravo Wellcare Network, LLC Family CurrentSince Jan 27, 2025 Accepting new patients

Locations

3625 NW 82nd Ave
Ste 400E1
Doral, FL 33166
Phone (786) 442-1869

5803 NW 151st St
Ste 206
Miami Lakes, FL 33014
Phone (305) 307-1911

Organizations & group practices 1

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": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1396213005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 E 8TH CT",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330103326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 E 8TH CT",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330103326",
            "telephone_number": "786-536-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO MATOS",
        "first_name": "ANGELA",
        "credential": "ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11000021",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11000021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.