Provider Demographics
NPI:1891677944
Name:BRAVO, EUNICE V
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:V
Last Name:BRAVO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7317 NW 174TH TER
Mailing Address - Street 2:APT. H-103
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-1120
Mailing Address - Country:US
Mailing Address - Phone:786-449-6363
Mailing Address - Fax:
Practice Address - Street 1:3625 NW 82ND AVE STE 100J
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6633
Practice Address - Country:US
Practice Address - Phone:305-980-2606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician