Kim Brazley, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9102785 Issued in FL

Practice address

1550 Barkley Cir
Fort Myers, FL 33907-4539

Phone

(239) 938-2000

Fax

(239) 278-0404

NPI assigned

Jul 2, 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 6

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Florida Heart Associates PL

  • Cardiovascular Disease Physician
  • Fort Myers, FL
  • NPI 1982709689
  Medicare reassignment
• Uniontown Medical Rehabilitation PC

  • Specialist
  • Uniontown, PA
  • NPI 1053378521
  NPD (past)

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1407885270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 BARKLEY CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074539",
            "telephone_number": "239-938-2000",
            "fax_number": "239-278-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 BARKLEY CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074539",
            "telephone_number": "239-938-2000",
            "fax_number": "239-278-0404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1002 Country Club Blvd",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339903025",
            "country_code": "US",
            "telephone_number": "239-938-2000",
            "fax_number": "239-278-0404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAZLEY",
        "first_name": "KIM",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "S64042",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12716838",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y06MR",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1858637",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107759500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM HEALTH",
            "identifier": "P1019612",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bernardo Ferreira Brasileiro, DDS, MS, PHD
• Airilis Bravo Milian
• Bravo Support Services Inc
• Cristina Elizabeth Bravo
• Lazaro Oscar Bravo Jr., M.D.
• Tamara L Bredar, PTA
• James O Breen, M.D.
• Brenda C. Hart, O.D., P.a. (Hart Eye Care)
• Nancy E Brennan, CRNA
• Adam Brenner, MD

• Medical Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.