Provider Demographics
NPI:1144465824
Name:J. BRAHMATEWARI M.D.P.A.
Entity type:Organization
Organization Name:J. BRAHMATEWARI M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-751-7771
Mailing Address - Street 1:PO BOX 226411
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33222-6411
Mailing Address - Country:US
Mailing Address - Phone:305-751-7771
Mailing Address - Fax:305-756-0270
Practice Address - Street 1:6301 BISCAYNE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-6284
Practice Address - Country:US
Practice Address - Phone:305-751-7771
Practice Address - Fax:305-756-0270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE5508ZOtherPTAN
FLH10467Medicare UPIN