Active NPI
Wound & Skin Experts
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- Plant City, FL
National Provider Identifier
1730578774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- 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, 2016
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014765700 | Medicaid | FL |
National Provider Directory
National Provider DirectoryLocations
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.