Brevard Pathology PA

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

ME 51687 Issued in FL

Legal business name

BREVARD PATHOLOGY PA

Practice address

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3585

Phone

(305) 666-2427

Fax

(305) 667-0239

NPI assigned

May 26, 2011

Organization subpart

No

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

Authorized official

Name

Marco Burenko, MD

Title

President

Phone

(305) 666-2427

Specialties & licenses 1

Addresses

Tax ID family

Brevard Pathology PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Brevard Pathology PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Melbourne, FL
  • NPI 1710270095
  NPD tax ID

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1124311964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 SAN REMO AVE",
            "address_2": "SUITE 280",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331463043",
            "telephone_number": "305-666-2427",
            "fax_number": "305-666-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W COCOA BEACH CSWY",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313585",
            "telephone_number": "305-666-2427",
            "fax_number": "305-667-0239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD PATHOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "BURENKO",
        "authorized_official_first_name": "MARCO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-666-2427",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME 51687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Bilder, LCSW
• Noah K Birch, FNP-C
• Brian Robert Boggs, MD
• Hassan Borghei, DO
• Aniela Jan Borowski, M.D.
• Brevard Pathology PA
• Ashley Briscoe, APRN
• Brenda Marie Britten, ARNP-C
• Richard Burklew III, LMHC
• Scott D. Bush, PH.D.

• All providers in Cocoa Beach, FL
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; 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.