BRADEN CLINIC LLC NPI 1871901157

NPI Information

NPI: 1871901157
Provider Name: BRADEN CLINIC LLC
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 10D2091997

Address:
5050 AVE MARIA BLVD
AVE MARIA, FL
ZIP 34142
Phone: (239) 867-4395
Get Directions

BRADEN CLINIC LLC is an urgent care clinic center in Ave Maria, FL. BRADEN CLINIC LLC NPI is 1871901157. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5050 AVE MARIA BLVD
AVE MARIA, FL
ZIP 34142-505
Phone: (239) 867-4395
Fax: (239) 217-3662

The provider's authorized official is Beau Braden .
The authorized official title is Manager and has the following contact phone number (239) 867-4395.

The CLIA number assigned to this NPI record is 10D2091997 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/30/2014 and was last updated on 11/28/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207P00000X	Emergency Medicine		OS12519	FLORIDA	No
2	207PT0002X	Emergency Medicine	Medical Toxicology	OS12519	FLORIDA	No
3	207L00000X	Anesthesiology		ME104654	FLORIDA	No
4	207QA0401X	Family Medicine	Addiction Medicine	OS12519	FLORIDA	No
5	208D00000X	General Practice		OS12519	FLORIDA	No
6	2084P0800X	Psychiatry & Neurology	Psychiatry	OS13007	FLORIDA	No
7	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	OS13007	FLORIDA	No
8	261QU0200X	Clinic/Center	Urgent Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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