Basic Information
Provider Information
NPI: 1922461508
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRAUN
FirstName: BENJAMIN
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3100 SW 62ND AVE
Address2:  
City: MIAMI
State: FL
PostalCode: 331553009
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3100 SW 62ND AVE
Address2:  
City: MIAMI
State: FL
PostalCode: 331553009
CountryCode: US
TelephoneNumber: 3056666511
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/01/2016
LastUpdateDate: 09/14/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0117X268542MAN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
390200000X268542MAN Student, Health CareStudent in an Organized Health Care Education/Training Program 
207XS0117XMD210313ORY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine

No ID Information.


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