Vanessa I Bravo, MS SLP CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA372 Issued in FL

Practice address

12224 Shady Forest Dr
Riverview, FL 33569-5632

Phone

(813) 671-0807

NPI assigned

Jan 9, 2007

Last updated

Feb 11, 2011By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297382400000",
    "number": "1457400863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12224 SHADY FOREST DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695632",
            "telephone_number": "813-671-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12224 SHADY FOREST DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695632",
            "telephone_number": "813-671-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "VANESSA",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "MS SLP CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2011-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887664900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "S1374",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "356413",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• De'Ayzia Bradford
• Anthony Lamont Bradley
• Jamaca Bradley, LCSW
• Desiree Brandow, PT, DPT
• Patrice Bratcher, MSCP
• Break the Silence Counseling (Daisy M. Deynes Bryant)
• Joseph James Breig, D.M.D. ENDODONTIST
• Amanda Brennan
• Allison Brett
• Jada Brewer

• Speech-Language Pathologist in Riverview, FL
• Providers in Riverview, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; 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.