PAUL G ROUSSEAU OD PA (NPI# 1265762918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265762918 |
| Entity Type | Organization |
| Organization Name | PAUL G ROUSSEAU OD PA |
| Practice Address |
5455 Murrell Rd Ste 107 Viera FL 32955-6615 |
| Practice Telephone | 3216361972 |
| Practice Fax Number | 3216361507 |
| Mailing Telephone | 3216361972 |
| Mailing Fax Number | 3216361507 |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2012-05-03 |
| Authorized Official Name | DR. PAUL GERARD ROUSSEAU (DEVELOPMENTAL OPTOMETRIST) |
| Authorized Official Telephone | 3216361972 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | OPC2641 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE PTAN | 20396Z | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003041906 | Paul G Rousseau Od Pa | Optometrist | 5455 Murrell Road, Suite 107, Melbourne, FL 32955-1986 | 2009-05-20 |
| Street Address |
5455 MURRELL RD STE 107 |
| City | VIERA |
| State | FL |
| Zip Code | 32955-6615 |
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|---|---|---|---|---|
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| 1588285100 | Enrique Technologies & Trading, LLC | Meals | 1841 Long Iron Dr. Ste. 805, Rockledge, FL 32955 | 2020-05-05 |
| 1578101549 | Ericka Marshall | Counselor | 7095 Turner Road, Rockledge, FL 32955 | 2019-12-20 |
| 1174168322 | Brevard Pharmacy L.L.C. | Pharmacy | 401. Barton Blvd., Rockledge, FL 32955 | 2019-11-12 |
| 1770131443 | Fyzical Therapy & Balance Center Rockledge-viera | Clinic/Center | 634 Barnes Boulevard, Unit 202, Rockledge, FL 32955 | 2019-08-27 |
| 1699261461 | Brookview Manor Assisted Living Facility LLC | Assisted Living Facility | 882 Brookview Ln, Rockledge, FL 32955 | 2018-07-05 |
| 1750888970 | Kaitlin Donovan | Dentist | 5380 Stadium Pkwy Ste 119, Rockledge, FL 32955 | 2018-04-13 |
| 1376041327 | Serina Eder | Acupuncturist | 5595 Schenck Ave Ste 7, Rockledge, FL 32955 | 2018-01-24 |
| 1427563394 | Suntree Orthopedics, LLC | Orthopaedic Surgery | 6525 3rd St Ste 302-303, Rockledge, FL 32955 | 2017-12-13 |
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| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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|---|---|---|---|---|
| 1356583165 | Reflections Obgyn LLC | Clinic/Center | 1705 Berglund Ln, Suite 102, Viera, FL 32940-6231 | 2009-03-26 |
| 1942250899 | Department of Veteran's Affairs | Clinic/Center | 2900 Veterans Way, Viera, FL 32940-8007 | 2006-05-11 |
| 1245297720 | Veterans Health Administration | Clinic/Center | 2900 Veterans Way, Viera, FL 32940-8007 | 2006-04-27 |
| 1659347037 | Viera Diagnostic Center LLC | Clinic/Center | 7000 Spyglass Ct, Suite 260, Viera, FL 32940-8288 | 2006-02-27 |
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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.