Basic Information
Provider Information
NPI: 1083915003
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TURNES-BRAVO
FirstName: CATHERINE
MiddleName: IRENE
NamePrefix: MRS.
NameSuffix:  
Credential: A.R.N.P
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9350 TURKEY LAKE ROAD
Address2:  
City: ORLANDO
State: FL
PostalCode: 32819
CountryCode: US
TelephoneNumber: 4073632772
FaxNumber: 4074479966
Practice Location
Address1: 9350 TURKEY LAKE ROAD
Address2:  
City: ORLANDO
State: FL
PostalCode: 32819
CountryCode: US
TelephoneNumber: 4073632772
FaxNumber: 4074479966
Other Information
ProviderEnumerationDate: 11/08/2010
LastUpdateDate: 11/08/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X9210225FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


Home