Andrea Viviana Bretal, MD

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME122080 Issued in FL

Practice address

1605 Town Center Blvd Ste D
Weston, FL 33326-3637

Phone

(954) 389-1800

Fax

(954) 389-7600

NPI assigned

Jan 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Neurofeedback Institute, PA

  • Clinical Psychologist
  • Weston, FL
  • NPI 1760208714
  NPD
• Careconnect Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Richland, GA
  • NPI 1063436624
  NPD (past)

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1558692145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 TOWN CENTER BLVD STE D",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263637",
            "telephone_number": "954-389-1800",
            "fax_number": "954-389-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 TOWN CENTER BLVD STE D",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263637",
            "telephone_number": "954-389-1800",
            "fax_number": "954-389-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETAL",
        "first_name": "ANDREA",
        "middle_name": "VIVIANA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "64777",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME122080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mauro Braun, M.D.
• Amy G.B. Bravo, PSY.D.
• Diana Y Bravo, M.S.,OTR/L
• Brenelly Lozada-Cruz, M.D., LLC
• Alan H Bresalier, DDS
• Luis Fernando Breton, DMD
• Caitlin Lily Brice, DO
• Alexandra E Briceno, RD, LDN, CDN
• Thomas Brickenden, RPH
• Brightways Behavioral Solutions Inc

• Primary Care Clinic/Center in Weston, FL
• Providers in Weston, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.