Floresita B Bravo Edora, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

12375 Issued in WV

Practice address

135 South Penn Avenue
Harrisville, WV 26362-0373

Phone

(304) 643-4005

Fax

(304) 643-4007

NPI assigned

Aug 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1407864465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 373",
            "address_2": "135 SOUTH PENN AVENUE",
            "city": "HARRISVILLE",
            "state": "WV",
            "postal_code": "263620373",
            "telephone_number": "304-643-4005",
            "fax_number": "304-643-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 SOUTH PENN AVENUE",
            "city": "HARRISVILLE",
            "state": "WV",
            "postal_code": "263620373",
            "telephone_number": "304-643-4005",
            "fax_number": "304-643-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO EDORA",
        "first_name": "FLORESITA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WV",
            "license": "12375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050558000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Harrisville, WV
• Providers in Harrisville, WV by specialty
• General Practice Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.