BREVARD HEALTH ALLIANCE (NPI# 1952451239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952451239 |
| Entity Type | Organization |
| Organization Name | BREVARD HEALTH ALLIANCE |
| Practice Address |
15 Rosa L Jones Blvd Cocoa FL 32922-7899 |
| Practice Telephone | 3216395177 |
| Mailing Telephone | 3216395177 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2010-11-04 |
| Authorized Official Name | MARSHA VENDETTI (OPERATIONS MANAGER) |
| Authorized Official Telephone | 3217225970 |
| 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 | 6886931-09 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679622120 | Brevard Health Alliance | Clinic/Center | 5270 Babcock St Ne # St1, Palm Bay, FL 32905-8630 | 2007-01-10 |
| 1528330826 | Brevard Health Alliance | Clinic/Center | 775 Malabar Rd, Malabar, FL 32950-3120 | 2012-02-01 |
| 1336444637 | Brevard Health Alliance | Clinic/Center | 500 N Washington Ave, Suite 105, Titusville, FL 32796-2759 | 2011-01-18 |
| 1174674956 | Brevard Health Alliance | Clinic/Center | 5270 Babcock St Ne # St1, Palm Bay, FL 32905-8630 | 2007-01-16 |
| 1518017896 | Brevard Health Alliance | Clinic/Center | 220 Barton Blvd, Unit C14, Rockledge, FL 32955-2742 | 2007-01-11 |
| 1619026218 | Brevard Health Alliance | Clinic/Center | 17 Silver Palm Ave, Melbourne, FL 32901-3123 | 2007-01-10 |
| 1992750962 | Brevard Health Alliance | Clinic/Center | 5270 Babcock St Ne, Suite 1, Palm Bay, FL 32905-8630 | 2006-05-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BREVARD HEALTH ALLIANCE, INC., THE | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 |
| Street Address |
15 ROSA L JONES BLVD |
| City | COCOA |
| State | FL |
| Zip Code | 32922-7899 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396260030 | Shacarra Danielle Pouncey | Behavioral Analyst | 453 King Street, Cocoa, FL 32922 | 2017-08-03 |
| 1851815849 | El-shaddai & Sons Maintenance LLC | Non-emergency Medical Transport (VAN) | 209 Factory St, Cocoa, FL 32922 | 2017-08-01 |
| 1891241949 | Stephanie B Duncan Kidwell | Developmental Therapist | 453 Cocoa St., Cocoa, FL 32922 | 2016-08-29 |
| 1861859746 | Ruth Ellis | Counselor | 7 N. Cocoa Blvd., Cocoa, FL 32922 | 2016-01-22 |
| 1528334109 | Cynthia Vicky Doyle | Counselor | 1407 Dixon Blvd., Cocoa, FL 32922 | 2012-03-28 |
| 1205156106 | Rhea Lucette Gibbs | Social Worker | 317 Riveredge B Lvd., Suite 104, Cocoa, FL 32922 | 2010-06-03 |
| 1871816439 | Suzanne P. Jasper-demarco | Behavioral Analyst | 550 Saint Johns St, Cocoa, FL 32922 | 2010-03-10 |
| 1023223294 | Loraine Catalano Schuh | Social Worker | 317 Riveredge Blvd, Suite 104, Cocoa, FL 32922 | 2007-05-11 |
| 1679795546 | Amber Elizabeth Bell | Counselor | Kidspeace, 633-b Brevard Avenue, Cocoa, FL 32922 | 2007-05-02 |
| 1154549343 | Venkata Naga Laxmi Cheedhella | Pharmacist | 1451 Dixon Blvd, Cocoa, FL 32922 | 2007-04-23 |
| Find all providers in zip 32922 | ||||
| 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 |
|---|---|---|---|---|
| 1700234770 | The Brevard Health Alliance Inc | Clinic/Center | 7227 N Us Highway 1, Cocoa, FL 32927-5020 | 2016-05-31 |
| 1962857417 | Brevard Health Alliance Inc | Clinic/Center | 7227 N Us Highway 1, Cocoa, FL 32927-5020 | 2016-05-03 |
| 1104121300 | The Brevard Health Alliance Inc | Clinic/Center | 705 Blake Ave, Bldg G, Cocoa, FL 32922-7100 | 2011-01-19 |
| 1730331109 | The Brevard Health Alliance Inc | Clinic/Center | 705 Blake Ave, Bldg G, Cocoa, FL 32922-7100 | 2008-10-16 |
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| Find all providers with the same taxonomy | ||||
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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.