Bravo, Leticia

Bravo, Leticia is an individual health care provider with primary practice located at 1411 N Race St , Glasgow KY 42141-3474. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bravo, Leticia can be contacted via phone (270) 651-9755.

Contact Information

Primary practice address
1411 N Race St Glasgow KY 42141-3474
Fax: (270) 651-7562
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 171002 Kentucky

Profile Details

NPI number 1164565180
LBN Legal business name Bravo, Leticia
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164565180 NPPES
Kentucky MEDICAID 64171002

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