MEDICAL ASSOCIATES OF BREVARD LLC (NPI# 1639592561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639592561 |
| Entity Type | Organization |
| Organization Name | MEDICAL ASSOCIATES OF BREVARD LLC |
| Practice Address |
575 S Wickham Rd Suite A Melbourne FL 32904-1170 |
| Practice Telephone | 3217278940 |
| Practice Fax Number | 3217337050 |
| Mailing Telephone | 3217278940 |
| Mailing Fax Number | 3217337050 |
| Enumeration Date | 2014-01-29 |
| Last Update Date | 2014-07-07 |
| Authorized Official Name | DR. GOPAL GADODIA (MD/AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 3212532900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
FL | Ambulatory Health Care Facilities |
| 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 |
| 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 |
| 1932330743 | Medical Associates of Brevard LLC | Clinic/Center | 2186 Harris Ave Ne, Suite 2, Palm Bay, FL 32905-4044 | 2009-07-29 |
| Street Address |
575 S WICKHAM RD SUITE A |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32904-1170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376621565 | Jennifer Baum | Physician Assistant | 575 S Wickham Rd, Melbourne, FL 32904-1170 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063066512 | Shepherd's Heart Ministries | Counselor | 900 S Wickham Rd, Melbourne, FL 32904 | 2019-08-01 |
| 1588138663 | Nicholle C Rothengass | Physician Assistant | 2263 W New Haven Ave # 350, W Melbourne, FL 32904 | 2019-01-11 |
| 1114407020 | Natalie Havkin | Speech-Language Pathologist | 250 S Wickham Rd., Melbourne, FL 32904 | 2018-08-20 |
| 1184119299 | Marni B Simon | Speech-Language Pathologist | 565 Acacia Ave, Melbourne Village, FL 32904 | 2018-06-30 |
| 1821588625 | Walden Psychological Services, LLC | Psychologist | 3400 Willowwood Dr, Melbourne, FL 32904 | 2018-05-16 |
| 1598276271 | Donetta Gwin Reynolds | Early Intervention Provider Agency | 764 Triples Crown Lane, West Melbourne, FL 32904 | 2017-10-20 |
| 1598205221 | Marathon Health, LLC | General Practice | 2550 Wingate Boulevard, C/o Brevard Wellcare- South, West Melbourne, FL 32904 | 2017-02-28 |
| 1366875387 | Cancer Center of Melbourne LLC | Clinic/Center | 415 S. Wickham Rd., Melbourne, FL 32904 | 2013-08-13 |
| 1558704312 | Sandra Suzanne Borthwick | Social Worker | 569 Sylvia Rd, Melbourne, FL 32904 | 2013-04-11 |
| 1396983607 | Genesis | Skilled Nursing Facility | 2653 Reflections Pl, W. Melbourne, FL 32904 | 2009-01-23 |
| Find all providers in zip 32904 | ||||
| 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 |
| 1619104114 | Medical Associates of Brevard LLC | Clinic/Center | 2290 W Eau Gallie Blvd, Suite 202, Melbourne, FL 32935-3145 | 2009-06-11 |
| 1093940470 | Medical Associates of Brevard LLC | Clinic/Center | 1535 W Nasa Blvd, Bld C Suite 103, Melbourne, FL 32901-2635 | 2009-05-28 |
| 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.