MEDICAL ASSOCIATES OF BREVARD LLC (NPI# 1932330743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932330743 |
| Entity Type | Organization |
| Organization Name | MEDICAL ASSOCIATES OF BREVARD LLC |
| Practice Address |
2186 Harris Ave Ne Suite 2 Palm Bay FL 32905-4044 |
| Practice Telephone | 3217258111 |
| Practice Fax Number | 3219840552 |
| Mailing Telephone | 3217258111 |
| Mailing Fax Number | 3219840552 |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2009-07-29 |
| Authorized Official Name | MR. GERARD L BESSETTE (ADMINISTRATOR) |
| Authorized Official Telephone | 3212532900 |
| 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 |
| 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 |
2186 HARRIS AVE NE SUITE 2 |
| City | PALM BAY |
| State | FL |
| Zip Code | 32905-4044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568466803 | James William Cobb Jr. | Optometrist | 2186 Harris Ave Ne, Ste 1, Palm Bay, FL 32905-4044 | 2005-06-01 |
| 1568510816 | Dr James W Cobb, Jr, Pa | Optometrist | 2186 Harris Ave Ne, Suite 1, Palm Bay, FL 32905-4044 | 2007-01-05 |
| 1013093491 | Liliana Mercedes Marshall | Dentist | 2186 Harris Ave Ne, Suite 3, Palm Bay, FL 32905-4044 | 2006-10-28 |
| 1841269693 | Carlton Craig Henry | Dentist | 2186 Harris Ave Ne, Suite 3, Palm Bay, FL 32905-4044 | 2006-03-15 |
| 1750367686 | Sharad Vyas | Pediatrics | 2186 Harris Ave Ne, Palm Bay, FL 32905-4044 | 2005-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306460928 | Lavell Woodard Jr. | Counselor | 4206 Pinewood Dr Ne, Palm Bay, FL 32905 | 2020-05-29 |
| 1548735699 | Aaron J Milton | Counselor | 1420 Sportsman Lane Ne, Palm Bay, FL 32905 | 2018-10-04 |
| 1871070417 | The Brevard Health Alliance Inc | Clinic/Center | 1361 Florida Ave Ne Ste 2, Palm Bay, FL 32905 | 2018-07-26 |
| 1699266361 | Coastal Visioncare LLC | Optometrist | 2186 Harris Ave Ne Ste 1, Palm Bay, FL 32905 | 2018-05-29 |
| 1184173981 | Jean Elyse Gautreaux | Social Worker | 2475 Palm Bay Rd Ne, Suite 130 #4, Palm Bay, FL 32905 | 2016-09-22 |
| 1174901607 | Reginald Shannon Seecharan | Developmental Therapist | 700 James Cir Ne, Palm Bay, FL 32905 | 2015-05-17 |
| 1881091254 | Courtney Taft | Physical Therapy Assistant | 1155 Malabar Road, Suite 1, Palm Bay, FL 32905 | 2014-12-01 |
| 1548513310 | Juda Marie Decara | Counselor | 4690 Lipscomb St Se, Suite 6c, Palm Bay, FL 32905 | 2012-10-18 |
| 1326308313 | Mohammad Idrees Md, P.a. | Internal Medicine | 1454 Belaire Lane N.e., Palm Bay, FL 32905 | 2012-05-23 |
| 1265704548 | Atm Amin Dds LLC | Dentist | 4620 Lipscomb St Ne, Suite 2, Palm Bay, FL 32905 | 2012-02-02 |
| Find all providers in zip 32905 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598323461 | Florida Health Care of Brevard | Clinic/Center | 1840 Eldron Blvd Se Ste 2, Palm Bay, FL 32909-6871 | 2019-06-04 |
| 1770821688 | Medical Associates of Brevard LLC | Clinic/Center | 6080 S. Babcock St. Se, Palm Bay, FL 32909-3921 | 2013-01-28 |
| 1285799791 | Medical Associates of Brevard LLC | Clinic/Center | 1051 Port Malabar Blvd Ne, # 9, Palm Bay, FL 32905-5153 | 2006-12-26 |
| 1013071489 | Medical Associates of Brevard LLC | Clinic/Center | 5055 Babcock St Ne, # 2, Palm Bay, FL 32905-4673 | 2006-12-20 |
| 1174531321 | Medical Associates of Brevard LLC | Clinic/Center | 910 Malabar Rd Se, Suite 2, Palm Bay, FL 32907-3200 | 2006-08-04 |
| 1245248954 | Medical Associates of Brevard LLC | Clinic/Center | 1071 Port Malabar Blvd Ne, Suite 111, Palm Bay, FL 32905-5161 | 2006-08-04 |
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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.