THE BREVARD HEALTH ALLIANCE INC (NPI# 1700234770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700234770 |
| Entity Type | Organization |
| Organization Name | THE BREVARD HEALTH ALLIANCE INC |
| Other Organization Name | PORT ST JOHN CLINIC |
| Practice Address |
7227 N Us Highway 1 Cocoa FL 32927-5020 |
| Mailing Address |
Po Box 1137 Melbourne FL 32902-1137 |
| Practice Telephone | 3218772740 |
| Mailing Telephone | 3219529696 |
| Mailing Fax Number | 3219527937 |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-05-31 |
| Authorized Official Name | ANGELA CRAIG (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 3212416834 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Port St John Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871070417 | The Brevard Health Alliance Inc | Clinic/Center | 1361 Florida Ave Ne Ste 2, Palm Bay, FL 32905 | 2018-07-26 |
| 1427363597 | The Brevard Health Alliance Inc | Clinic/Center | 1537 N Singleton Ave, Titusville, FL 32796-1679 | 2010-08-13 |
| 1104121300 | The Brevard Health Alliance Inc | Clinic/Center | 705 Blake Ave, Bldg G, Cocoa, FL 32922-7100 | 2011-01-19 |
| 1730331109 | The Brevard Health Alliance Inc | Clinic/Center | 705 Blake Ave, Bldg G, Cocoa, FL 32922-7100 | 2008-10-16 |
| Street Address |
7227 N US HIGHWAY 1 |
| City | COCOA |
| State | FL |
| Zip Code | 32927-5020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053813154 | Eduardo Diaz | Psychologist | 7227 N Us Highway 1, Cocoa, FL 32927-5020 | 2018-03-05 |
| 1487100582 | Patricia Monaghan | Psychologist | 7227 N Us Highway 1, Cocoa, FL 32927-5020 | 2016-08-29 |
| 1962857417 | Brevard Health Alliance Inc | Clinic/Center | 7227 N Us Highway 1, Cocoa, FL 32927-5020 | 2016-05-03 |
| 1982058269 | Paige Perales | Nurse Practitioner | 7227 N Us Highway 1, Cocoa, FL 32927-5020 | 2016-04-22 |
| 1831591494 | Carl Clinton Wilkinson IIi | Dentist | 7227 N Us Highway 1, Cocoa, FL 32927-5020 | 2014-09-25 |
| 1477816601 | Desra Kay Clark | Family Medicine | 7227 N Us Highway 1, Cocoa, FL 32927-5020 | 2012-06-22 |
| 1306139019 | Jennifer Alongi | Dentist | 7227 N Us Highway 1, Cocoa, FL 32927-5020 | 2011-05-27 |
| 1225357973 | Mourad Abouelleil | Urology | 7227 N Us Highway 1, Suite 220, Cocoa, FL 32927-5020 | 2010-05-20 |
| 1306088802 | Donna L Bacon Pa | Family Medicine | 7227 N Us Highway 1, Cocoa, FL 32927-5004 | 2009-03-30 |
| 1043343478 | Marie Tuite Muller | Family Medicine | 7227 N Us Highway 1, Cocoa, FL 32927-5020 | 2007-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538565023 | Susan Guattery Coleman | Dietitian, Registered | 7075 Us Highway 1, Diabetes Education Suite 300, Port Saint John, FL 32927 | 2014-11-10 |
| 1245668086 | Betty Lopez Munarriz | Contractor | 5660 Fay Blvd, Cocoa, FL 32927 | 2013-10-14 |
| 1427499599 | Gary Ray Rudolph | Pharmacist | 7125 Us 1, Cocoa, FL 32927 | 2013-07-17 |
| 1659716165 | Tania Melissa Johnson | Social Worker | 5355 Date Palm St, Cocoa, FL 32927 | 2013-05-10 |
| 1538473137 | Irwin Jaraplasan | Dentist | 5235 Fay Blvd, Cocoa, FL 32927 | 2010-08-06 |
| 1386856110 | Tri M Le | Pharmacist | 6257 U.S. Hwy 1, Cocoa, FL 32927 | 2007-05-04 |
| 1134218357 | Rameshwar N Mathur Md Pa | Family Medicine | 6250 N Us 1, Cocoa, FL 32927 | 2006-10-12 |
| 1922035088 | Albino Y Kuon | Psychiatry & Neurology | 4360 North Us1, Cocoa, FL 32927 | 2006-06-26 |
| 1801855424 | Faye Ellen O'rourke | Nurse Practitioner | 7227 N. Us Hwy. 1, Port St. John, FL 32927 | 2006-03-22 |
| 1063965275 | Tiffany Williams-brown | Nurse Practitioner | 860 Camp Rd, Cocoa, FL 32927 | 2016-07-25 |
| Find all providers in zip 32927 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952451239 | Brevard Health Alliance | Clinic/Center | 15 Rosa L Jones Blvd, Cocoa, FL 32922-7899 | 2007-01-11 |
| 1962857417 | Brevard Health Alliance Inc | Clinic/Center | 7227 N Us Highway 1, Cocoa, FL 32927-5020 | 2016-05-03 |
| 1104121300 | The Brevard Health Alliance Inc | Clinic/Center | 705 Blake Ave, Bldg G, Cocoa, FL 32922-7100 | 2011-01-19 |
| 1730331109 | The Brevard Health Alliance Inc | Clinic/Center | 705 Blake Ave, Bldg G, Cocoa, FL 32922-7100 | 2008-10-16 |
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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.