Individual provider Active NPI

Diana Y Bravo, M.S.,OTR/L

  • Rehabilitation Practitioner
  • Weston, FL
National Provider Identifier
1700907078
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
OT 10831 Issued in FL
Practice address
2900 S Commerce Pkwy
Weston, FL 33331-3622
Phone
(954) 385-6281
Fax
(954) 385-6289
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X OT 10831 FL Primary

Addresses

Primary practice location

2900 S Commerce Pkwy
Weston, FL 33331-3622

Mailing address

2900 S Commerce Pkwy
Weston, FL 33331-3622
Phone (954) 385-6281

Other identifiers 1

IdentifierTypeStateIssuer
8902054 00MedicaidFL

Other names 1

  • Diana Y Estrada Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OT 10831FLMDRehabilitation Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1700907078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 S COMMERCE PKWY",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313622",
            "telephone_number": "954-385-6281",
            "fax_number": "954-385-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S COMMERCE PKWY",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313622",
            "telephone_number": "954-385-6281",
            "fax_number": "954-385-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "DIANA",
        "middle_name": "Y",
        "credential": "M.S.,OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "FL",
            "license": "OT 10831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902054 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "ESTRADA",
            "middle_name": "Y",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Weston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.