Provider Demographics
NPI:1144475856
Name:BRAUT, JOHN PAUL (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:BRAUT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E OLYMPIA AVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-3823
Mailing Address - Country:US
Mailing Address - Phone:941-637-2663
Mailing Address - Fax:941-637-6872
Practice Address - Street 1:315 E OLYMPIA AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3823
Practice Address - Country:US
Practice Address - Phone:941-637-2663
Practice Address - Fax:941-637-6872
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12175207X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14QT3OtherBC/BS OF FLORIDA
FLHO819YOtherMEDICARE
FL591563145OtherUHC