FOOT AND ANKLE ASSOCIATES OF BREVARD LLC (NPI# 1114465515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114465515 |
| Entity Type | Organization |
| Organization Name | FOOT AND ANKLE ASSOCIATES OF BREVARD LLC |
| Practice Address |
4020 Fair Point Ln Melbourne FL 32934-8436 |
| Practice Telephone | 3219609040 |
| Mailing Telephone | 3219609040 |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |
| Authorized Official Name | DR. JARED BRIANT MOYLES (OWNER) |
| Authorized Official Telephone | 3219609040 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | PO 3545 | FL | Podiatric Medicine & Surgery Service Providers |
| Street Address |
4020 FAIR POINT LN |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32934-8436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013530419 | Ryan Thomas Kammerdener | Pharmacist | 3003 Bay Wind Ct, Melbourne, FL 32934 | 2020-05-20 |
| 1558833731 | Deborah J Gaffney | Specialist/Technologist | 3060 Kershaw Court, Melbourne, FL 32934 | 2018-12-27 |
| 1548703200 | Damaris Escarment | Counselor | 3550 W. Eau Gallie Blvd, Melbourne, FL 32934 | 2016-11-29 |
| 1447686324 | Sarai Escarment | Counselor | 3550 W Eau Gallie Blvd, Melbourne, FL 32934 | 2013-09-23 |
| 1871874974 | Felipe E. Dominguez, Md, Pa | Clinical Medical Laboratory | 3030 Venture Lane, Ste 108, Melbourne, FL 32934 | 2011-09-01 |
| 1376821637 | Christine Natasha Williams Kelly | Counselor | 4450 West Eau Gallie Blvd, Suite 200, Melbourne, FL 32934 | 2011-08-03 |
| 1912203316 | Sheryl Yatsko | Physical Therapy Assistant | 3303 Sarno Rd, Melbourne, FL 32934 | 2011-02-01 |
| 1255564191 | Joy Cheryl Mullen | Occupational Therapy Assistant | 1890 Whispering Oaks Cir, West Melbourne, FL 32934 | 2009-08-26 |
| 1619031531 | The Devereux Foundation | Case Management | 1591 Robert J Conlan Boulevard, Palm Bay, FL 32934 | 2006-12-22 |
| 1457456600 | Jo A Kologlu | Physical Therapist | 5025 Smithfield Rd, Melbourne, FL 32934 | 2006-09-13 |
| Find all providers in zip 32934 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609201227 | Patricia A Russo | Podiatrist | 2958 Ingram Ave, Melbourne, IA 50162-9559 | 2013-09-13 |
| 1710096862 | Daniel Albert Cohen | Podiatrist | 7730 N Wickham Rd, Suite 103, Melbourne, FL 32940 | 2006-08-30 |
| 1619986429 | Brian Stanley Wieszbicki | Podiatrist | 1375 Cypress Trace Dr, Melbourne, FL 32940-1623 | 2006-08-08 |
| 1437181666 | Stanley Ira Gabe | Podiatrist | 129 W Hibiscus Ave, Suite C, Melbourne, FL 32901 | 2006-07-07 |
| 1669455291 | Brian Joseph Mallette | Podiatrist | 200 S Harbor City Blvd, Suite 102, Melbourne, FL 32901-1384 | 2005-11-29 |
| 1174506877 | Briant G Moyles Dpm Pa | Podiatrist | 211 E New Haven Ave, Melbourne, FL 32901-4503 | 2005-11-28 |
| 1306273545 | Iowa Podiatry Care, Inc. | Podiatrist | 2958 Ingram Ave, Melbourne, IA 50162-9559 | 2013-10-02 |
| 1558701243 | Jessica Ann Ortega Wilson | Podiatrist | 1515 Airport Blvd, Melbourne, FL 32901 | 2013-06-27 |
| 1184064834 | Thomas Charles Wilson | Podiatrist | 1515 Airport Blvd, Melbourne, FL 32901 | 2013-06-26 |
| 1457589244 | Jared Briant Moyles | Podiatrist | 1515 Airport Blvd, Melbourne, FL 32901 | 2009-06-30 |
| Find all providers in MELBOURNE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.