Organization Active NPI

Wound & Skin Experts

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Plant City, FL
National Provider Identifier
1730578774
Registry record updated Aug 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
Legal business name
WOUND & SKIN EXPERTS
Practice address
1514 S Alexander St
Suite 204
Plant City, FL 33563-8415
Phone
(813) 754-7756
Fax
(813) 754-7565
NPI assigned
Jan 14, 2015
Last updated
Aug 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2016

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

Authorized official

Name
Dr. Juan O Bravo, M.D
Title
Provider/Owner
Phone
(863) 398-8362

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X NU Primary

Addresses

Primary practice location

1514 S Alexander St
Suite 204
Plant City, FL 33563-8415

Mailing address

1514 S Alexander St
Suite 204
Plant City, FL 33563-8415
Phone (813) 754-7756

Other identifiers 1

IdentifierTypeStateIssuer
014765700MedicaidFL

National Provider Directory

National Provider Directory

Locations

1111 S Highland Ave
Clearwater, FL 33756
Phone (727) 244-1379

NPI Registry JSON

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470009600000",
    "number": "1730578774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 S ALEXANDER ST",
            "address_2": "SUITE 204",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335638415",
            "telephone_number": "813-754-7756",
            "fax_number": "813-754-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 S ALEXANDER ST",
            "address_2": "SUITE 204",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335638415",
            "telephone_number": "813-754-7756",
            "fax_number": "813-754-7565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND & SKIN EXPERTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-14",
        "last_updated": "2016-08-01",
        "status": "A",
        "authorized_official_last_name": "BRAVO",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "863-398-8362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014765700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; 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.