BREVARD GERIATRICS, LLC (NPI# 1225682784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225682784 |
| Entity Type | Organization |
| Organization Name | BREVARD GERIATRICS, LLC |
| Practice Address |
720 E New Haven Ave Suite 11 Melbourne FL 32901-5474 |
| Practice Telephone | 3217244545 |
| Practice Fax Number | 3217284168 |
| Mailing Telephone | 3217244545 |
| Mailing Fax Number | 3217284168 |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-08-01 |
| Authorized Official Name | JOHN POTOMSKI (OWNER) |
| Authorized Official Telephone | 3214465893 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 067596200 | 05 |
| Street Address |
720 E NEW HAVEN AVE SUITE 11 |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-5474 |
| 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 | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730682642 | Centennial Medical Group | Family Medicine | 1341 Bedford Drive, Melbourne, FL 32940 | 2018-03-16 |
| 1063983138 | Transitional Care Management LLC | Family Medicine | 1341 Bedford Dr Ste B, Melbourne, FL 32940-1986 | 2018-12-16 |
| 1346392362 | Vasudeva R Nalipireddy | Family Medicine | 469 N Harbor City Blvd, Melbourne, FL 32935-6857 | 2007-01-18 |
| 1851355093 | Ningyi Huang | Family Medicine | 720 E New Haven Ave, Melbourne, FL 32901 | 2006-04-14 |
| 1730160607 | Paul R. Biggs | Family Medicine | 1223 Gateway Drive, Melbourne, FL 32901-2607 | 2005-11-08 |
| 1760478796 | Visalakshi Srinivasan | Family Medicine | 3661 S Babcock St, 2nd Floor, Melbourne, FL 32901-8903 | 2005-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821620618 | Heather J Cappello LLC | Family Medicine | 2571 Dick Wilson Dr, Sarasota, FL 34240-8722 | 2020-02-10 |
| 1922562933 | Bless Medical Center Corp | Family Medicine | 440 E Sample Road Suite 107, Pompano Beach, FL 33064 | 2019-01-23 |
| 1184137929 | Saint George Medical Center Inc | Family Medicine | 1118 Hospital Rd, Fort Walton Beach, FL 32547-6742 | 2017-11-15 |
| 1750835211 | Gainesville Geriatric Rehabilitation Medicine LLC | Family Medicine | 5002 Nw 15th Pl, Gainesville, FL 32605-4555 | 2016-08-12 |
| 1033570171 | Reliance Med, LLC | Family Medicine | 8450 Reymont St, Orlando, FL 32827-7430 | 2016-03-17 |
| 1013375062 | Kravitz Physician Services, P.a. | Family Medicine | 5150 Nw 82nd Ter, Coral Springs, FL 33067-2811 | 2016-02-05 |
| 1972968089 | Wm R George II Md Pa | Family Medicine | 327 Plaza Real Ste 307, Boca Raton, FL 33432-3944 | 2015-12-17 |
| 1710369020 | Robert N. Baskin, Md, P.a. | Family Medicine | 2108 N Golfview Dr, Plant City, FL 33566-6768 | 2015-06-23 |
| 1437557766 | Geriatric Care Associates LLC | Family Medicine | 10238 Sw 86th Cir, Suite 300, Ocala, FL 34481-7626 | 2014-12-18 |
| 1083026447 | Avalon Wellness Services LLC | Family Medicine | 6845 S Tropical Trl, Merritt Island, FL 32952-6512 | 2014-05-20 |
| 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.