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Contact Information

WADE J BRAVO, PA
1381 S PATRICK DRIVE
45TH MEDICAL GROUP
PATRICK AFB, FL32925
 Phone: 321-494-8159
 Fax: 321-494-1378
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for WADE J BRAVO · (Male)

NPI Number 1023085255
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 03/07/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # PA2830
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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