Brevard Community Pathology Services LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BREVARD COMMUNITY PATHOLOGY SERVICES LLC

Practice address

1555 Saxon Blvd Ste 502
Deltona, FL 32725-5869

Phone

(386) 574-1481

Fax

(386) 574-8812

NPI assigned

Feb 17, 2007

Organization subpart

No

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

Authorized official

Name

Sudhir K VarmaNPI 1972000990

Title

Ceo

Phone

(386) 574-1481

Specialties & licenses 1

Addresses

Other names 1

• MEDICAL ARTS LABORATORY OF DELTONA Doing business as

Locations

Practitioners 1

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

• Sudhir K Varma, MD

  • Clinical Pathology/Laboratory Medicine Physician
  • Deltona, FL
  • NPI 1972000990
  NPD (past) Authorized official

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562889600000",
    "number": "1295879674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 SAXON BLVD STE 502",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327255869",
            "telephone_number": "386-574-1481",
            "fax_number": "386-574-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SAXON BLVD STE 502",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327255869",
            "telephone_number": "386-574-1481",
            "fax_number": "386-574-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD COMMUNITY PATHOLOGY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-17",
        "last_updated": "2019-07-12",
        "status": "A",
        "authorized_official_last_name": "VARMA",
        "authorized_official_first_name": "SUDHIR",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "386-574-1481"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL ARTS LABORATORY OF DELTONA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ginna Lorraine Bouali
• Mary Currie Branch
• Paula Braniff, RDH
• Kayla Brant, FNP-BC
• Breathe Sleep Dream LLC
• Jaia Bright, RBT 21168991
• Christopher W Brim, APRN
• Jennifer Diamond Brinson
• Jeanette Elaine Brissett, L.P.T.A
• Makayla Brown

• Clinical Medical Laboratory in Deltona, FL
• Providers in Deltona, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.