NPIMap

Organization Active NPI

Surgical Associates of Brevard LLC

  • Surgery Physician
  • Rockledge, FL
National Provider Identifier
1003144270
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SURGICAL ASSOCIATES OF BREVARD LLC
Practice address
1004 Beverly Dr
Suite a
Rockledge, FL 32955-2851
Phone
(321) 637-2150
Fax
(321) 637-2155
NPI assigned
Nov 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sandi Laroche
Title
Credentialing Coordinator
Phone
(321) 449-4168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1004 Beverly Dr
Suite a
Rockledge, FL 32955-2851

Mailing address

150 N Sykes Creek Pkwy
# 300
Merritt Island, FL 32953-3488
Phone (321) 449-4168

National Provider Directory

National Provider Directory

Locations

8055 Spyglass Hill Rd
Melbourne, FL 32940
Phone (321) 637-2150

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284076800000",
    "number": "1003144270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N SYKES CREEK PKWY",
            "address_2": "# 300",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533488",
            "telephone_number": "321-449-4168",
            "fax_number": "321-449-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 BEVERLY DR",
            "address_2": "SUITE A",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552851",
            "telephone_number": "321-637-2150",
            "fax_number": "321-637-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES OF BREVARD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-30",
        "last_updated": "2010-09-10",
        "status": "A",
        "authorized_official_last_name": "LAROCHE",
        "authorized_official_first_name": "SANDI",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "321-449-4168"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.