MEDICAL ASSOCIATES OF BREVARD LLC (NPI# 1376553073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376553073 |
| Entity Type | Organization |
| Organization Name | MEDICAL ASSOCIATES OF BREVARD LLC |
| Other Organization Name | MEDICAL ASSOCIATES OF BREVARD, P.A. |
| Practice Address |
1400 Pine St Suite A Melbourne FL 32901-3170 |
| Practice Telephone | 3216766000 |
| Practice Fax Number | 3216767000 |
| Mailing Telephone | 3216766000 |
| Mailing Fax Number | 3216767000 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2007-09-26 |
| Authorized Official Name | GERARD L. BESSETTE (ADMINISTRATOR) |
| Authorized Official Telephone | 3217289657 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDICAL ASSOCIATES OF BREVARD LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Medical Associates of Brevard, P.A. | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770821688 | Medical Associates of Brevard LLC | Clinic/Center | 6080 S. Babcock St. Se, Palm Bay, FL 32909-3921 | 2013-01-28 |
| 1639189251 | Medical Associates of Brevard LLC | Clinic/Center | 901 Jordan Blass Dr, Suite 103, Melbourne, FL 32940-1824 | 2006-08-08 |
| 1679582605 | Medical Associates of Brevard LLC | Clinic/Center | 580 N Wickham Rd, Suite A, Melbourne, FL 32935-8400 | 2006-08-07 |
| 1992128508 | Medical Associates of Brevard LLC | Clinic/Center | 2290 W Eau Gallie Blvd, Suite 110, Melbourne, FL 32935-3133 | 2014-02-03 |
| 1538582366 | Medical Associates of Brevard LLC | Clinic/Center | 575 S Wickham Rd, Suite A, West Melbourne, FL 32904-1170 | 2014-01-30 |
| 1639592561 | Medical Associates of Brevard LLC | Clinic/Center | 575 S Wickham Rd, Suite A, Melbourne, FL 32904-1170 | 2014-01-29 |
| 1942570098 | Medical Associates of Brevard LLC | Internal Medicine | 8045 Spyglass Hill Road, Suite 102, Melbourne, FL 32940-8567 | 2012-01-06 |
| 1053689810 | Medical Associates of Brevard LLC | Internal Medicine | 1301 W Eau Gallie Blvd Ste 108, Melbourne, FL 32935-5390 | 2011-12-08 |
| 1538476726 | Medical Associates of Brevard LLC | Obstetrics & Gynecology | 304 S Harbor City Blvd, Suite 101, Melbourne, FL 32901-1382 | 2010-09-09 |
| 1689987596 | Medical Associates of Brevard LLC | Internal Medicine | 397 N Wickham Rd, Suite 101, Melbourne, FL 32935-8669 | 2010-07-20 |
| Street Address |
1400 PINE ST SUITE A |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-3170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548293442 | Parvesh K. Bansal | Internal Medicine | 1400 Pine St, Suite A, Melbourne, FL 32901-3170 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696766 | Advanced Healthcare Integration, LLC | Clinic/Center | 445 Pineda Ct Ste 200, Melbourne, FL 32940-7555 | 2020-10-13 |
| 1942792429 | Ethos Health Melbourne, LLC | Clinic/Center | 2755 N Wickham Rd Ste 102, Melbourne, FL 32935-2226 | 2018-05-31 |
| 1639189251 | Medical Associates of Brevard LLC | Clinic/Center | 901 Jordan Blass Dr, Suite 103, Melbourne, FL 32940-1824 | 2006-08-08 |
| 1679582605 | Medical Associates of Brevard LLC | Clinic/Center | 580 N Wickham Rd, Suite A, Melbourne, FL 32935-8400 | 2006-08-07 |
| 1649896804 | Tricoche Integrated Health Inc | Clinic/Center | 1855 W Hibiscus Blvd, Melbourne, FL 32901-2622 | 2020-06-23 |
| 1487270831 | Space Health LLC | Clinic/Center | 3800 W Eau Gallie Blvd Ste 101, Melbourne, FL 32934-3285 | 2020-06-22 |
| 1659841914 | Biocellular Therapies Inc | Clinic/Center | 2290 W Eau Gallie Blvd Ste 210b, Melbourne, FL 32935-3145 | 2018-11-29 |
| 1992128508 | Medical Associates of Brevard LLC | Clinic/Center | 2290 W Eau Gallie Blvd, Suite 110, Melbourne, FL 32935-3133 | 2014-02-03 |
| 1639592561 | Medical Associates of Brevard LLC | Clinic/Center | 575 S Wickham Rd, Suite A, Melbourne, FL 32904-1170 | 2014-01-29 |
| 1619104114 | Medical Associates of Brevard LLC | Clinic/Center | 2290 W Eau Gallie Blvd, Suite 202, Melbourne, FL 32935-3145 | 2009-06-11 |
| 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.