BREVARD KIDNEY & HYPERTENSION INC (NPI# 1235211327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235211327 |
| Entity Type | Organization |
| Organization Name | BREVARD KIDNEY & HYPERTENSION INC |
| Practice Address |
245 S Courtenay Pkwy Bldg A Merritt Island FL 32952 |
| Practice Telephone | 3214520020 |
| Practice Fax Number | 3214534366 |
| Mailing Telephone | 3214520020 |
| Mailing Fax Number | 3214534366 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. SUKON K WANICH (ADMINISTRATOR) |
| Authorized Official Telephone | 3214520020 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS OF FL | V78 | 01 |
| Street Address |
245 S COURTENAY PKWY BLDG A |
| City | MERRITT ISLAND |
| State | FL |
| Zip Code | 32952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306945993 | Hany I Girgis | Internal Medicine | 245 S Courtenay Pkwy, Merritt Island, FL 32952-4856 | 2006-09-21 |
| 1720482243 | Anny Daneshvar | Social Worker | 245 S Courtenay Pkwy, Merritt Island, FL 32952-4831 | 2014-10-13 |
| 1528242849 | Rai Care Centers of Merritt Island LLC | Clinic/Center | 245 S Courtenay Pkwy, Building A, Merritt Island, FL 32952-4856 | 2007-12-21 |
| 1811085749 | Ellery E Canlas | Internal Medicine | 245 S Courtenay Pkwy, Merritt Island, FL 32952-4831 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841761673 | Pushpa Daliya | Physical Medicine & Rehabilitation | 1200 S Courtenay Pkwy, Merritt Island, FL 32952 | 2018-12-05 |
| 1407335458 | Merritt Island Outpatient Surgery Center, LLC | Clinic/Center | 450 E Merritt Island Cswy Ste 400, Merritt Island, FL 32952 | 2018-08-10 |
| 1760903272 | Harold A Utt Jr. | Audiologist | 105 N. Banana River Drive, Merritt Island, FL 32952 | 2017-07-06 |
| 1942720982 | Cadiz Senior Care | Assisted Living Facility | 1970 Farrington Drive, Merritt Island, FL 32952 | 2017-06-21 |
| 1891230884 | Jessica Orcel | Behavioral Analyst | 1680 E. Central Avenue, Merritt Island, FL 32952 | 2016-12-29 |
| 1770039539 | Haley Haskins | Student in an Organized Health Care Education/Training Program | 1655 Yates Dr., Merritt Island, FL 32952 | 2016-08-31 |
| 1891150900 | Kristin Stevenson | Case Management | 262 Island Beach Blvd, Mirritt Island, FL 32952 | 2015-12-17 |
| 1568835080 | Brilliant Smiles Orthodontics | Health Maintenance Organization | 455 Magnolia Avenue, Merritt Island, FL 32952 | 2015-11-05 |
| 1184967184 | Roseann Judith Simone | Assisted Living Facility | 280 Bahama Dr, Angel Guardian, Cocoa Beach, FL 32952 | 2013-03-28 |
| 1942558861 | Daven H Patel | Dentist | 800 E. Merritt Island Causeway, Merritt Island, FL 32952 | 2012-08-27 |
| Find all providers in zip 32952 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528242849 | Rai Care Centers of Merritt Island LLC | Clinic/Center | 245 S Courtenay Pkwy, Building A, Merritt Island, FL 32952-4856 | 2007-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496104 | Kidney Care Center of Winter Haven LLC | Clinic/Center | 1107 3rd St Sw Ste 9, Winter Haven, FL 33880-3912 | 2020-10-27 |
| 1538773411 | 5072020, LLC | Clinic/Center | 2675 Winkler Ave Ste 130, Fort Myers, FL 33901-9362 | 2020-09-08 |
| 1750992814 | Swain Dialysis Renal Center | Clinic/Center | 1923 Nw 43rd St, Miami, FL 33142-4777 | 2020-08-12 |
| 1396355525 | Kidney Partners Coral Gables LLC | Clinic/Center | 835 Sw 37th Ave, Miami, FL 33135-4289 | 2020-08-03 |
| 1427668870 | Dialysis Spa, LLC | Clinic/Center | 2040 Ne 163rd St Ste 206, North Miami Beach, FL 33162-4953 | 2020-07-31 |
| 1285250522 | Fresenius Medical Care Casselberry, LLC | Clinic/Center | 775 Gateway Dr Ste 1010, Altamonte Springs, FL 32714-1524 | 2020-06-23 |
| 1992321244 | Fresenius Medical Care Casselberry, LLC | Clinic/Center | 750 Northlake Blvd Ste 1024, Altamonte Springs, FL 32701-6745 | 2020-06-23 |
| 1023630886 | Fresenius Medical Care Apollo Beach, LLC | Clinic/Center | 3002 E College Ave, Ruskin, FL 33570-5220 | 2020-05-14 |
| 1124640263 | Arc Dialysis Westchester LLC | Clinic/Center | 11501 Sw 40th St Ste 100, Miami, FL 33165-3313 | 2020-05-12 |
| 1487274734 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 2777 University Blvd W Ste 39, Jacksonville, FL 32217-2143 | 2020-04-16 |
| Find all providers with the same taxonomy | ||||
| City | MERRITT ISLAND |
| Zip Code | 32952 |
Please comment or provide details below to improve the information on BREVARD KIDNEY & HYPERTENSION INC.
| 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.