Organization Active NPI

Children'S Healthcare of Brevard

  • Pediatrics Physician
  • Melbourne, FL
National Provider Identifier
1346075942
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDREN'S HEALTHCARE OF BREVARD
Practice address
2351 W Eau Gallie Blvd Ste 4
Melbourne, FL 32935-3114
Phone
(321) 775-0477
Fax
(321) 775-0476
NPI assigned
Sep 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Authorized official

Name
Ms. Margaret Witzleb, ARNPNPI 1114980364
Title
Nurse-Practitioner Owner
Phone
(321) 775-0477

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2351 W Eau Gallie Blvd Ste 4
Melbourne, FL 32935-3114

Mailing address

2351 W Eau Gallie Blvd Ste 4
Melbourne, FL 32935-3114
Phone (321) 775-0477

National Provider Directory

National Provider Directory

Locations

2351 W Eau Gallie Blvd
Ste 4
Melbourne, FL 32935
Phone (321) 242-3242

Practitioners & affiliated clinicians

Practitioners 1

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": "1725408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725408000000",
    "number": "1346075942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 W EAU GALLIE BLVD STE 4",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353114",
            "telephone_number": "321-775-0477",
            "fax_number": "321-775-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 W EAU GALLIE BLVD STE 4",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353114",
            "telephone_number": "321-775-0477",
            "fax_number": "321-775-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HEALTHCARE OF BREVARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-04",
        "last_updated": "2024-09-04",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "WITZLEB",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "NURSE-PRACTITIONER OWNER",
        "authorized_official_telephone_number": "321-775-0477",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "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 Sep 4, 2024; 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.