Most Relevant Information
Provider Data
| NPI Number: | 1003068552 |
| Provider Name: | WANDA LAVERNE MCGOWAN-BRAYNEN ARNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2200X |
| Specialty: | Nurse Practitioner |
| License Number: | ARNP1750042 |
Most Important Dates
| Enumeration Date: | 10/15/2008 |
| Last Updated: | 10/15/2008 |
Provider Practice Location
1611 NW 12TH AVE
MIAMI
FL
331361005
Practice Location Phone/Fax
| Phone: | 3055851111 |
| Fax: | 3059999941 |
Provider Mailing Location
20315 NW 3RD CT
MIAMI GARDENS
FL
331692526
Provider Mailing Phone/Fax
| Phone: | 3056512386 |
| Fax: | 3059999941 |