BREVARD SPECIALTY SURGERY CENTER LLC (NPI# 1558694034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558694034 |
| Entity Type | Organization |
| Organization Name | BREVARD SPECIALTY SURGERY CENTER LLC |
| Practice Address |
95 Bulldog Boulevard Suite 104 Melbourne FL 32901-3175 |
| Practice Telephone | 3219529800 |
| Practice Fax Number | 3219527889 |
| Mailing Telephone | 3219529800 |
| Mailing Fax Number | 3219527889 |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2010-04-15 |
| Authorized Official Name | DR. STEPHEN FITZGERALD (PRESIDENT) |
| Authorized Official Telephone | 3219529800 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities | ||
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
846 | FL | Ambulatory Health Care Facilities |
| Street Address |
95 BULLDOG BOULEVARD SUITE 104 |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-3175 |
| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326527680 | Intracoastal Surgery Center, LLC | Clinic/Center | 2200 W Eau Gallie Blvd Ste 100, Melbourne, FL 32935-3166 | 2018-08-08 |
| 1669803391 | Surgery Center of Viera LLC | Clinic/Center | 7955 Spyglass Hill Rd Ste B, Melbourne, FL 32940-8249 | 2013-12-05 |
| 1306087135 | Crane Creek Surgical Partners, LLC | Clinic/Center | 2222 South Harbor City Blvd, Suite 540, Melbourne, FL 32901 | 2009-03-06 |
| 1164473922 | Ophthalmology Center of Brevard Lp | Clinic/Center | 719 E New Haven Ave, Melbourne, FL 32901-5459 | 2006-05-15 |
| 1558323956 | Melbourne Surgery Center Lp | Clinic/Center | 1340 Medical Park Dr, Suite 101, Melbourne, FL 32901-3246 | 2006-04-03 |
| 1174594584 | Sheridan Surgery Center | Clinic/Center | 95 Bulldog Blvd, Ste104, Melbourne, FL 32901-3332 | 2006-02-01 |
| 1255311635 | Melbourne Asc Lp | Clinic/Center | 1401 S Apollo Blvd, Suite B, Melbourne, FL 32901-3179 | 2006-01-20 |
| 1063495257 | Doctors Surgical Partnership Ltd | Clinic/Center | 1035 S Apollo Blvd, Melbourne, FL 32901-1969 | 2005-11-22 |
| 1013309459 | Melbourne Surgery Center, LLC | Clinic/Center | 95 Bulldog Blvd, Suite 104, Melbourne, FL 32901-3332 | 2015-02-23 |
| 1568644490 | Harbor City Surgical Care | Clinic/Center | 211 E New Haven Ave, Suite 1, Melbourne, FL 32901-4503 | 2007-12-03 |
| 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.