NPIMap

Organization Active NPI

Viera Family Practice PA

  • Family Medicine Physician
  • Melbourne, FL
National Provider Identifier
1073546701
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME85423 Issued in FL
Legal business name
VIERA FAMILY PRACTICE PA
Practice address
8095 Spyglass Hill Rd
Suite 105
Melbourne, FL 32940-8290
Phone
(321) 242-7005
Fax
(321) 242-7009
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Dr. Mahmoud Mostafavi, M.D.
Title
Physician
Phone
(321) 242-7005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME85423 FL Primary

Addresses

Primary practice location

8095 Spyglass Hill Rd
Suite 105
Melbourne, FL 32940-8290

Mailing address

8095 Spyglass Hill Rd
Suite 105
Melbourne, FL 32940-8290
Phone (321) 242-7005

National Provider Directory

National Provider Directory

Locations

8095 Spyglass Hill Rd
Ste 105
Viera, FL 32940
Phone (321) 242-7005

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1073546701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8095 SPYGLASS HILL RD",
            "address_2": "SUITE 105",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408290",
            "telephone_number": "321-242-7005",
            "fax_number": "321-242-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8095 SPYGLASS HILL RD",
            "address_2": "SUITE 105",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408290",
            "telephone_number": "321-242-7005",
            "fax_number": "321-242-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIERA FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "MOSTAFAVI",
        "authorized_official_first_name": "MAHMOUD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "321-242-7005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME85423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.