MR. WILLIAM J BROUSSARD (NPI# 1609827096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609827096 |
| Entity Type | Individual |
| Full Name | MR. WILLIAM J BROUSSARD |
| Credential | MD |
| Practice Address |
502 E. New Haven Ave. Melbourne FL 32901-5427 |
| Practice Telephone | 3217272020 |
| Practice Fax Number | 3219849547 |
| Mailing Telephone | 3217272020 |
| Mailing Fax Number | 3219849547 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2014-04-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | ME9669 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 068370100 | 05 | |
| FL | BLUE CROSS/BLUE SHIELD | 05235 | 01 |
| FL | CCN | 166168 | 01 |
| FL | AETNA HMO | 2000323 | 01 |
| FL | FIRST HEALTH | 704370 | 01 |
| FL | CIGNA | 9259919003 | 01 |
| FL | RAILROAD MEDICARE | 180032675 | 01 |
| FL | AETNA PPO | 4038993 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043217961 | William Fred Broussard | Pharmacist | 5415 Sw Beaverton Hillsdale Hwy, Portland, OR 97221-1918 | 2005-07-07 |
| Street Address |
502 E. NEW HAVEN AVE. |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-5427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932150455 | David S Weiser | Ophthalmology | 502 E. New Haven Ave., Melbourne, FL 32901-5427 | 2006-05-12 |
| 1184675415 | Fred A Lundquist | Optometrist | 502 E. New Haven Ave., Melbourne, FL 32901-5427 | 2006-05-12 |
| 1154372605 | L Neal Freeman | Ophthalmology | 502 E. New Haven Ave., Melbourne, FL 32901-5427 | 2006-05-12 |
| 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 | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316447725 | Florida Eye Associates, Inc. | Ophthalmology | 509 E New Haven Ave, Melbourne, FL 32901-5461 | 2018-02-13 |
| 1477075703 | Florida Eye Associates Inc | Ophthalmology | 5510 Murrell Rd, Melbourne, FL 32940-6373 | 2017-07-07 |
| 1932150455 | David S Weiser | Ophthalmology | 502 E. New Haven Ave., Melbourne, FL 32901-5427 | 2006-05-12 |
| 1477503696 | Rafael Trespalacios | Ophthalmology | 665 S Apollo Blvd, Melbourne, FL 32901-1485 | 2006-05-10 |
| 1801846027 | Tracy B Ravin | Ophthalmology | 502 E. New Haven Ave, Melbourne, FL 32901-5427 | 2006-05-10 |
| 1295706570 | Jason J. Ross | Ophthalmology | 502 E New Haven Ave, Melbourne, FL 32901-5427 | 2006-01-27 |
| 1174514053 | James N Mcmanus | Ophthalmology | 1995 W Nasa Blvd, Suite 200, Melbourne, FL 32904-2300 | 2005-10-31 |
| 1770574642 | Vrinda S Hershberger | Ophthalmology | 502 E. New Haven Avenue, Melbourne, FL 32901 | 2005-10-31 |
| 1972598308 | Jason K Darlington | Ophthalmology | 1995 W. Nasa Blvd, Suite 200, Melbourne, FL 32904 | 2005-09-12 |
| 1629062401 | Pinnacle Eye Center Inc | Ophthalmology | 1649 W Eau Gallie Blvd, Ste 100, Melbourne, FL 32935-4160 | 2005-09-07 |
| Find all providers in MELBOURNE | ||||
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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.