Leticia Bravo, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9197551 Issued in FL

Practice address

306 Union Ave
Crescent City, FL 32112-4432

Phone

(386) 698-1232

Fax

(386) 698-4154

NPI assigned

Oct 6, 2014

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

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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AWCHU1
• FHIR API: https://fhir4.healow.com/fhir/r4/EFIECD
• FHIR API: https://fhir4.healow.com/fhir/r4/IFGECD

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.

• Rural Health Care Incorporated

  dba Aza Health

  • Federally Qualified Health Center (FQHC)
  • Palatka, FL
  • NPI 1871569061
  Medicare reassignment NPD
• Rural Health Care Inc

  dba Aza Health

  • Federally Qualified Health Center (FQHC)
  • Daytona Beach, FL
  • NPI 1811429806
  NPD
• Rural Health Care, Inc.

  dba Aza Health

  • Federally Qualified Health Center (FQHC)
  • Daytona Beach, FL
  • NPI 1891227179
  NPD
• Soma Medical Center, P. a #4

  • Pediatrics Physician
  • Lake Worth, FL
  • NPI 1184920613
  NPD (past)
• Soma Medical Center, PA

  dba Rafael O. Nunez

  • Internal Medicine Physician
  • Palm Springs, FL
  • NPI 1467499038
  NPD (past)

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1427451327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 RIVER ST",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321775042",
            "telephone_number": "386-328-0108",
            "fax_number": "386-325-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 UNION AVE",
            "city": "CRESCENT CITY",
            "state": "FL",
            "postal_code": "321124432",
            "telephone_number": "386-698-1232",
            "fax_number": "386-698-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "LETICIA",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-06",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9197551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015856600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alan Gommel, D.C.
• Thomas P Ball, RPH, CPH, CPE
• Michael Berry, PA
• Beyond Venacare Services LLC
• Kimberly Sue Bryan, OTR/L
• Mary Bustos
• Doris Ann Carroll, LMHC, MCAP
• Tamara Nadia Cepeda
• Community Pharmacy Inc (Community Pharmacy)

• Family Nurse Practitioner in Crescent City, FL
• Providers in Crescent City, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.