BREVARD PATHOLOGY PA (NPI# 1710270095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710270095 |
| Entity Type | Organization |
| Organization Name | BREVARD PATHOLOGY PA |
| Practice Address |
8745 N Wickham Rd Melbourne FL 32940-5997 |
| Mailing Address |
1500 San Remo Ave Suite 280 Coral Gables FL 33146-3043 |
| Practice Telephone | 3056662427 |
| Practice Fax Number | 3056670239 |
| Mailing Telephone | 3056662427 |
| Mailing Fax Number | 3056661065 |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2011-05-19 |
| Authorized Official Name | MARCO BURENKO (PRESIDENT) |
| Authorized Official Telephone | 3056662427 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
ME 51687 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124311964 | Brevard Pathology Pa | Pathology | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2011-05-26 |
| 1619947835 | Brevard Pathology Pa | Pathology | 699 W Cocoa Bch Cswy, Ste 203, Cocoa Beach, FL 32931 | 2006-01-23 |
| Street Address |
8745 N WICKHAM RD |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32940-5997 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558311464 | Beth Ann Burns | Internal Medicine | 8745 N Wickham Rd, Viera Hospital.hospitalist Dept, Melbourne, FL 32940-5997 | 2006-05-11 |
| 1518444124 | Devin King | Pharmacist | 8745 N Wickham Rd, Melbourne, FL 32940-5997 | 2018-07-26 |
| 1316478571 | Maria De Los M. Colon Perez | Internal Medicine | 8745 N Wickham Rd, Melbourne, FL 32940-5997 | 2017-03-21 |
| 1477940260 | Wael Sankar | Hospitalist | 8745 N Wickham Rd, Melbourne, FL 32940 | 2015-04-20 |
| 1073925442 | Kelvin Diosiris Santos | Internal Medicine | 8745 N Wickham Rd, Melbourne, FL 32940-5997 | 2014-05-20 |
| 1689961864 | Angela Candelaria | Internal Medicine | 8745 N Wickham Rd, Melbourne, FL 32940-5997 | 2011-07-07 |
| 1083900377 | Vanessa Joann Ohleyer | Internal Medicine | 8745 N Wickham Rd, Melbourne, FL 32940 | 2011-06-24 |
| 1730494816 | Viera Hospital, Inc. | General Acute Care Hospital | 8745 N Wickham Rd, Attention: Administration, Melbourne, FL 32940-5997 | 2010-08-12 |
| 1053649566 | Stephanie Prada | Hospitalist | 8745 N Wickham Rd, Melbourne, FL 32940-5997 | 2009-11-20 |
| 1629270632 | Dean A. Post | Family Medicine | 8745 N Wickham Rd, Melbourne, FL 32940-5997 | 2007-06-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700403649 | True Motion Physical Therapy and Wellness | Clinic/Center | 3536 Peninsula Circle, Mlebourne, FL 32940 | 2020-06-26 |
| 1568089431 | Live Gracefully Physio and Wellness, Pllc | Clinic/Center | 6470 Shadow Creek Trail, Apt 5204, Melbourne, FL 32940 | 2020-06-26 |
| 1295360592 | Hiteshi Patel | Pharmacist | 3134 Hummingbird Way, Melbourne, FL 32940 | 2020-03-06 |
| 1972133122 | Curtis Lynn Curbo | Social Worker | 3830 Fringetree Lane, Melbourne, FL 32940 | 2020-01-16 |
| 1861038283 | Medfast Urgent Care Centers, LLC | Clinic/Center | 5500 Stadium Parkway, Melbourne, FL 32940 | 2019-11-20 |
| 1134601594 | Caroline Grace Bennett | Behavior Technician | 5500 Murrell Rd Suite 100, Melbourne, FL 32940 | 2018-09-02 |
| 1730682642 | Centennial Medical Group | Family Medicine | 1341 Bedford Drive, Melbourne, FL 32940 | 2018-03-16 |
| 1356849251 | Executive Non-emergency Transportation, Inc. | Non-emergency Medical Transport (VAN) | 3155-02 Suntree Blvd, Melbourne, FL 32940 | 2018-01-25 |
| 1679081160 | Brevard Oaks Center, LLC | Skilled Nursing Facility | 2355 Vidina Drive, Viera, FL 32940 | 2018-01-18 |
| 1275045817 | Comfortable Care Dental Health Professionals. P.a. | Dentist | 6340 N Wickham Rd Ste 101, Melbourne, FL 32940 | 2017-11-03 |
| Find all providers in zip 32940 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497963862 | Sean Arie Cote | Pathology | 27 E. Hibiscus Blvd, Melbourne, FL 32901 | 2007-05-18 |
| 1265550115 | Nasreen Qazi | Pathology | 4470 Portage Trail, Melbourne, FL 32940 | 2007-03-27 |
| 1982002473 | Brevard Pathology Services Pa | Pathology | 1350 Hickory St, Melbourne, FL 32901-3224 | 2014-12-15 |
| 1184606188 | Space Coast Pathologists Pa | Pathology | 1350 S Hickory St, Dept. of Pathology, Melbourne, FL 32901-3278 | 2005-11-16 |
| 1376525360 | Aneal S. Masih | Pathology | 1350 S Hickory St, Dept. of Pathology, Melbourne, FL 32901-3278 | 2005-11-16 |
| 1619959657 | Charles H. Chodorow | Pathology | 1350 S Hickory St, Dept. of Pathology, Melbourne, FL 32901-3278 | 2005-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780157321 | Richard Freij | Pathology | 9770 S Military Trl # B4-255, Boynton Beach, FL 33436-3207 | 2019-01-07 |
| 1447755137 | Brian Steven Mccarthy I | Pathology | 1719 Nw 23rd Ave Apt 1f, Gainesville, FL 32605-3005 | 2018-03-26 |
| 1841716123 | Kritika Krishnamurthy | Pathology | 4300 Alton Rd Ste 2400, Miami Beach, FL 33140-2948 | 2017-08-17 |
| 1982154167 | Johnny Paul Hughes | Pathology | 18317 Cypress Stand Cir, Tampa, FL 33647-1816 | 2016-10-11 |
| 1154870657 | Clinical Toxicology Pa | Pathology | 10269 Sw Village Pkwy, 102, Port Saint Lucie, FL 34987-2369 | 2016-09-25 |
| 1932584281 | Nichole Allen | Pathology | 2210 Marsh View Dr Unit 104, Wesley Chapel, FL 33544-4712 | 2015-07-29 |
| 1710368501 | Archi Patel | Pathology | 18311 Highwoods Preserve Pkwy Unit 6413, Tampa, FL 33647-1925 | 2015-06-17 |
| 1265839377 | Hugo Keiji Kaneku Nagahama | Pathology | 1600 Nw 10th Ave Rm 8149, Miami, FL 33136-1015 | 2014-12-04 |
| 1508278532 | Daniel Sanchez | Pathology | 7000 Sw 62nd Ave Ste 601, South Miami, FL 33143 | 2014-05-26 |
| 1508277799 | Kyle White | Pathology | 7188 Estero Dr, Lake Worth, FL 33463-5600 | 2014-05-11 |
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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.