THE BREVARD HEALTH ALLIANCE INC (NPI# 1871070417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871070417 |
| Entity Type | Organization |
| Organization Name | THE BREVARD HEALTH ALLIANCE INC |
| Other Organization Name | BHA EVANS CENTER CLINIC |
| Practice Address |
1361 Florida Ave Ne Ste 2 Palm Bay FL 32905 |
| Mailing Address |
Po Box 1137 Melbourne FL 32902-1137 |
| Practice Telephone | 3212416800 |
| Practice Fax Number | 3212416888 |
| Mailing Telephone | 3219529696 |
| Mailing Fax Number | 3219527937 |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2018-08-21 |
| 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 |
|---|---|
| BHA Evans Center Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427363597 | The Brevard Health Alliance Inc | Clinic/Center | 1537 N Singleton Ave, Titusville, FL 32796-1679 | 2010-08-13 |
| 1700234770 | The Brevard Health Alliance Inc | Clinic/Center | 7227 N Us Highway 1, Cocoa, FL 32927-5020 | 2016-05-31 |
| 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 |
1361 FLORIDA AVE NE STE 2 |
| City | PALM BAY |
| State | FL |
| Zip Code | 32905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558849885 | The Brevard Health Alliance, Inc. | General Practice | 1361 Florida Ave Ne Ste 2, Palm Bay, FL 32905 | 2018-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306460928 | Lavell Woodard Jr. | Counselor | 4206 Pinewood Dr Ne, Palm Bay, FL 32905 | 2020-05-29 |
| 1548735699 | Aaron J Milton | Counselor | 1420 Sportsman Lane Ne, Palm Bay, FL 32905 | 2018-10-04 |
| 1699266361 | Coastal Visioncare LLC | Optometrist | 2186 Harris Ave Ne Ste 1, Palm Bay, FL 32905 | 2018-05-29 |
| 1184173981 | Jean Elyse Gautreaux | Social Worker | 2475 Palm Bay Rd Ne, Suite 130 #4, Palm Bay, FL 32905 | 2016-09-22 |
| 1174901607 | Reginald Shannon Seecharan | Developmental Therapist | 700 James Cir Ne, Palm Bay, FL 32905 | 2015-05-17 |
| 1881091254 | Courtney Taft | Physical Therapy Assistant | 1155 Malabar Road, Suite 1, Palm Bay, FL 32905 | 2014-12-01 |
| 1548513310 | Juda Marie Decara | Counselor | 4690 Lipscomb St Se, Suite 6c, Palm Bay, FL 32905 | 2012-10-18 |
| 1326308313 | Mohammad Idrees Md, P.a. | Internal Medicine | 1454 Belaire Lane N.e., Palm Bay, FL 32905 | 2012-05-23 |
| 1265704548 | Atm Amin Dds LLC | Dentist | 4620 Lipscomb St Ne, Suite 2, Palm Bay, FL 32905 | 2012-02-02 |
| 1003186040 | Julie Artley | Pharmacist | 1213 Palm Bay Rd, Ne, Melbourne, FL 32905 | 2012-01-09 |
| Find all providers in zip 32905 | ||||
| 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 |
|---|---|---|---|---|
| 1679622120 | Brevard Health Alliance | Clinic/Center | 5270 Babcock St Ne # St1, Palm Bay, FL 32905-8630 | 2007-01-10 |
| 1174674956 | Brevard Health Alliance | Clinic/Center | 5270 Babcock St Ne # St1, Palm Bay, FL 32905-8630 | 2007-01-16 |
| 1316004815 | Brevard Health Alliance Inc | Clinic/Center | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 | 2007-01-03 |
| 1992750962 | Brevard Health Alliance | Clinic/Center | 5270 Babcock St Ne, Suite 1, Palm Bay, FL 32905-8630 | 2006-05-24 |
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| Find all providers with the same taxonomy | ||||
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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.