BREVARD HEALTH ALLIANCE INC (NPI# 1790056877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790056877 |
Entity Type | Organization |
Organization Name | BREVARD HEALTH ALLIANCE INC |
Other Organization Name | MALABAR CLINIC |
Practice Address |
775 Malabar Rd Malabar FL 32950-3120 |
Practice Telephone | 3217228435 |
Practice Fax Number | 3217228486 |
Mailing Telephone | 3217228435 |
Mailing Fax Number | 3217228486 |
Enumeration Date | 2012-01-20 |
Last Update Date | 2013-04-04 |
Authorized Official Name | ANGELA CRAIG (BUSINESS OFFICE MANAGER) |
Authorized Official Telephone | 3219529696 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 6886931-14 | 05 |
Other Name | Type Code |
---|---|
Malabar Clinic | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073855797 | Brevard Health Alliance Inc | Clinic/Center | 4000 N Riverside Dr, Indian Harbour Beach, FL 32937-4842 | 2013-03-20 |
1124660527 | Brevard Health Alliance Inc | Pharmacy | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 | 2019-10-17 |
1780226555 | Brevard Health Alliance Inc | Pharmacy | 1537 N Singleton Ave, Titusville, FL 32796-1679 | 2019-10-14 |
1811539687 | Brevard Health Alliance Inc | Pharmacy | 220 Barton Blvd Unit C14, Rockledge, FL 32955-2742 | 2019-10-14 |
1285111732 | Brevard Health Alliance Inc | Pharmacy | 2120 Sarno Rd, Melbourne, FL 32935-3084 | 2018-07-26 |
1962857417 | Brevard Health Alliance Inc | Clinic/Center | 7227 N Us Highway 1, Cocoa, FL 32927-5020 | 2016-05-03 |
1902244486 | Brevard Health Alliance Inc | Clinic/Center | 2120 Sarno Rd, Melbourne, FL 32935-3084 | 2013-06-06 |
1013355726 | Brevard Health Alliance Inc | Clinic/Center | 2120 Sarno Rd, Melbourne, FL 32935-3084 | 2013-06-05 |
1285976480 | Brevard Health Alliance Inc | Clinic/Center | 4000 N Riverside Dr, Indian Harbour Beach, FL 32937-4842 | 2013-03-26 |
1639413925 | Brevard Health Alliance Inc | Clinic/Center | 220 Barton Blvd, Unit C14, Rockledge, FL 32955-2742 | 2012-11-27 |
Street Address |
775 MALABAR RD |
City | MALABAR |
State | FL |
Zip Code | 32950-3120 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891774899 | Geraldine Ann Halstead | Nurse Practitioner | 775 Malabar Rd, Malabar, FL 32950-3155 | 2006-01-10 |
1184286478 | Mindy Leanne Strickland | Nurse Practitioner | 775 Malabar Rd, Malabar, FL 32950-3120 | 2019-07-08 |
1356853360 | Tracy Zapanta | Nurse Practitioner | 775 Malabar Rd, Malabar, FL 32950-3120 | 2017-10-31 |
1518338839 | Lakeecia Cannion | Registered Nurse | 775 Malabar Rd, Malabar, FL 32950-3120 | 2015-10-13 |
1801289707 | Leigh Anne Potts | Nurse Practitioner | 775 Malabar Rd, Malabar, FL 32950-3120 | 2015-03-17 |
1528330826 | Brevard Health Alliance | Clinic/Center | 775 Malabar Rd, Malabar, FL 32950-3120 | 2012-02-01 |
1467735225 | Vanessa Hinckson | Pediatrics | 775 Malabar Rd, Malabar, FL 32950-3120 | 2011-09-27 |
1124327234 | Christine L Justice | Nurse Practitioner | 775 Malabar Rd, Malabar, FL 32950-3120 | 2011-03-16 |
1770731291 | Palm Bay Pediatrics | Pediatrics | 775 Malabar Rd, Malabar, FL 32950-3120 | 2008-09-09 |
1346459435 | Stephanie Blazak Napoli | Psychologist | 775 Malabar Rd, Malabar, FL 32950-3120 | 2007-05-22 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417589771 | Urgent Care Centers of Brevard County LLC | Clinic/Center | 730 Malabar Rd Ne, Ste B, Malabar, FL 32950 | 2020-02-05 |
1649741794 | Joanne Schneider | Technician | 1731 Country Cove Circle, Malabar, FL 32950 | 2018-12-16 |
1760952667 | Amy Nies | Social Worker | 1040 Steeplechase Cir, Malabar, FL 32950 | 2018-12-04 |
1548260326 | Kiron Malhotra | Internal Medicine | 730 Malabar Rd Ste A, Malabar, FL 32950 | 2005-07-22 |
1467437004 | Bhaskerrao P Patel | Internal Medicine | 730 Malabar Rd Ste A, Malabar, FL 32950 | 2005-12-07 |
1194052118 | Charlene D Gilbert | Home Health Aide | 2165 Weber Rd, Malabar, FL 32950-3119 | 2009-11-12 |
1588654008 | Allen R Condo | Family Medicine | 730 Malabar Rd Ste B, Malabar, FL 32950-3140 | 2005-10-26 |
1770576332 | Kyle R. Anderson | Internal Medicine | 730 Malabar Rd, Malabar, FL 32950-3140 | 2005-08-29 |
1073514337 | Kurt Samuel Hensel | Orthopaedic Surgery | 730 Malabar Rd Ste C, Malabar, FL 32950-3140 | 2005-08-09 |
1669032025 | Kelly Campbell Owens | Physician Assistant | 730 Malabar Rd Ste B, Malabar, FL 32950-3140 | 2019-06-18 |
Find all providers in zip 32950 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528330826 | Brevard Health Alliance | Clinic/Center | 775 Malabar Rd, Malabar, FL 32950-3120 | 2012-02-01 |
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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.