NPIMap

Organization Active NPI

Brevard Eye Center

  • Eyewear Supplier
  • Titusville, FL
National Provider Identifier
1184849523
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
BREVARD EYE CENTER
Practice address
1401 S Washington Ave
Titusville, FL 32780-4295
Phone
(321) 267-2980
Fax
(321) 267-2983
NPI assigned
Apr 13, 2007
Last updated
Jun 30, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
BREVARD EYE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Authorized official

Name
Mr. Gary R Hardey
Title
Ceo
Phone
(321) 984-2346

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU Primary

Addresses

Primary practice location

1401 S Washington Ave
Titusville, FL 32780-4295

Mailing address

665 S Apollo Blvd
Melbourne, FL 32901-1485
Phone (321) 984-2346

Other identifiers 6

IdentifierTypeStateIssuer
0539980006OtherDEMERC TV
1942346911OtherNPI REYNOLDS
1558456681OtherNPI GROUP
086944907MedicaidFL
1003075730OtherNPI DELATORRE
252338807MedicaidFL

Other names 1

  • Paul J Befanis MD PA Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Brevard Eye Center9 organizations share this tax ID, including this one
Part of
Brevard Eye Center

Other organizations with this tax ID 8

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

Locations

1401 S Washington Ave
Titusville, FL 32780
Phone (321) 267-2980

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1184849523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 S APOLLO BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011485",
            "telephone_number": "321-984-2346",
            "fax_number": "321-984-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327804295",
            "telephone_number": "321-267-2980",
            "fax_number": "321-267-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD EYE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BREVARD EYE CENTER",
        "enumeration_date": "2007-04-13",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "HARDEY",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "321-984-2346",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEMERC TV",
            "identifier": "0539980006",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI REYNOLDS",
            "identifier": "1942346911",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP",
            "identifier": "1558456681",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "086944907",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI DELATORRE",
            "identifier": "1003075730",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252338807",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paul J Befanis MD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.