MEDICAL ASSOCIATES OF BREVARD LLC (NPI# 1477562403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477562403 |
| Entity Type | Organization |
| Organization Name | MEDICAL ASSOCIATES OF BREVARD LLC |
| Other Organization Name | MEDICAL ASSOCIATES OF BREVARD, P.A. |
| Practice Address |
401 N Wickham Rd Suite H Melbourne FL 32935-8659 |
| Practice Telephone | 3217575105 |
| Practice Fax Number | 3217575104 |
| Mailing Telephone | 3217575105 |
| Mailing Fax Number | 3217575104 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2007-09-26 |
| Authorized Official Name | GERARD L. BESSETTE (ADMINISTRATOR) |
| Authorized Official Telephone | 3217289657 |
| 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 |
| Other Name | Type Code |
|---|---|
| Medical Associates of Brevard, P.A. | Former Legal Business Name - Organization |
| 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 |
401 N WICKHAM RD SUITE H |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32935-8659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306836952 | Poonam Mishra | Family Medicine | 401 N Wickham Rd, Suite H, Melbourne, FL 32935-8659 | 2005-10-25 |
| 1669750873 | Brevard Hma Hme, LLC | Durable Medical Equipment & Medical Supplies | 401 N Wickham Rd, Suite K, Melbourne, FL 32935-8659 | 2011-07-22 |
| 1295051845 | Ashwini Healthcare LLC | Pharmacy | 401 N Wickham Rd, Suite W and X, Melbourne, FL 32935-8659 | 2010-04-07 |
| 1134231079 | The Affordable Apothecary Inc | Pharmacy | 401 N Wickham Rd, Ste E, Melbourne, FL 32935-8659 | 2006-08-31 |
| 1366463226 | Jay E. Olsson, D.o., P.a. | Physical Medicine & Rehabilitation | 401 N Wickham Rd, Suite S, Melbourne, FL 32935-8659 | 2006-07-23 |
| 1144264904 | Jay Edward Olsson | Physical Medicine & Rehabilitation | 401 N Wickham Rd, Suite S, Melbourne, FL 32935-8659 | 2006-06-15 |
| 1841234721 | Christopher Stanley Cole | Physician Assistant | 401 N Wickham Rd, Suite S, Melbourne, FL 32935-8659 | 2006-06-15 |
| 1265415103 | Michelle Jane Madan | Nurse Practitioner | 401 N Wickham Rd, Suite S, Melbourne, FL 32935-8659 | 2005-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407412018 | Aleecia Estime | Nurse Practitioner | 401 N Wickham Rd Ste S, Melbourne, FL 32935 | 2019-05-20 |
| 1669948261 | Lisa Marie Sarkees | Social Worker | 1503 Spring Drive, Melbourne, FL 32935 | 2018-10-22 |
| 1407355399 | Eugene Slaughter | Case Manager/Care Coordinator | 1600 W Eau Gallie Blvd. Suite 201 F, Melbourne, FL 32935 | 2018-02-06 |
| 1588173173 | Gregory M Mcdermand | Respiratory Therapist, Certified | 2745 Revolution St, Unit 101, Melbourne, FL 32935 | 2017-09-26 |
| 1386173649 | M Shami | Nurse Practitioner | 401 N Wickham Rd. Suite S, Melbourne, FL 32935 | 2017-06-08 |
| 1588102297 | Chiro Choice A Limited Liability Company | Clinic/Center | 1310 W Eau Galle Blvd Ste A, Melbourne, FL 32935 | 2017-02-02 |
| 1124574835 | A Loving Touch Private Home Care | Home Health | 1595 Palmwood Drive, Melbourne, FL 32935 | 2016-09-01 |
| 1538616099 | Pedro Triana Villamil | Specialist/Technologist, Other | 1600 Sarno Rd. Suite 15, Melbourne, FL 32935 | 2016-09-01 |
| 1528424132 | Lisa Forsythe | Acupuncturist | 1250 W. Eau Gallie Blvd., Suite H, Melbourne, FL 32935 | 2016-01-12 |
| 1528432028 | Harbor City Pharmacy Inc | Pharmacy | 503 Harbor City Blvd., Melbourne, FL 32935 | 2015-11-20 |
| Find all providers in zip 32935 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696766 | Advanced Healthcare Integration, LLC | Clinic/Center | 445 Pineda Ct Ste 200, Melbourne, FL 32940-7555 | 2020-10-13 |
| 1942792429 | Ethos Health Melbourne, LLC | Clinic/Center | 2755 N Wickham Rd Ste 102, Melbourne, FL 32935-2226 | 2018-05-31 |
| 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 |
| 1649896804 | Tricoche Integrated Health Inc | Clinic/Center | 1855 W Hibiscus Blvd, Melbourne, FL 32901-2622 | 2020-06-23 |
| 1487270831 | Space Health LLC | Clinic/Center | 3800 W Eau Gallie Blvd Ste 101, Melbourne, FL 32934-3285 | 2020-06-22 |
| 1659841914 | Biocellular Therapies Inc | Clinic/Center | 2290 W Eau Gallie Blvd Ste 210b, Melbourne, FL 32935-3145 | 2018-11-29 |
| 1992128508 | Medical Associates of Brevard LLC | Clinic/Center | 2290 W Eau Gallie Blvd, Suite 110, Melbourne, FL 32935-3133 | 2014-02-03 |
| 1639592561 | Medical Associates of Brevard LLC | Clinic/Center | 575 S Wickham Rd, Suite A, Melbourne, FL 32904-1170 | 2014-01-29 |
| 1619104114 | Medical Associates of Brevard LLC | Clinic/Center | 2290 W Eau Gallie Blvd, Suite 202, Melbourne, FL 32935-3145 | 2009-06-11 |
| Find all providers in MELBOURNE | ||||
Please comment or provide details below to improve the information on MEDICAL ASSOCIATES OF BREVARD LLC.
| 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.