Provider Demographics
NPI:1730189150
Name:BRAUSS, JAMES (PA)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:BRAUSS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:
Practice Address - Street 1:2301 WILTON DR
Practice Address - Street 2:UNIT C1
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1202
Practice Address - Country:US
Practice Address - Phone:954-764-6906
Practice Address - Fax:954-463-7933
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1072152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3446264OtherAETNA
FL084758500Medicaid
FL19523OtherBLUE CROSS BLUE SHIELD
FL220833OtherAVMED
FL19523ZMedicare PIN
FL3446264OtherAETNA
FL0545640001Medicare NSC
FLT84040Medicare UPIN