Pediatrics in Brevard, P.a.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRICS IN BREVARD, P.A.

Practice address

699 W Cocoa Beach Cswy Ste 401
Cocoa Beach, FL 32931-3562

Phone

(321) 784-5437

Fax

(321) 799-1231

NPI assigned

Nov 2, 2005

Organization subpart

No

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

Authorized official

Name

Melissa Loiselle

Title

Credentialing Coordinator

Phone

(321) 877-4438

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626134400000",
    "number": "1417948043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 W COCOA BEACH CSWY",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313577",
            "telephone_number": "321-784-5437",
            "fax_number": "321-799-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 W COCOA BEACH CSWY STE 401",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313562",
            "telephone_number": "321-784-5437",
            "fax_number": "321-799-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS IN BREVARD, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-02",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A",
        "authorized_official_last_name": "LOISELLE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "321-877-4438"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253255705",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pramesh Patel, M.D.
• Shivani Patel, PA-C
• Robert H Paxson, M.D.
• Peace Club Inc. (Peace Club)
• Pediatrics in Brevard, P.a.
• Brittany Lauren Peeler, DNP
• Kristen M Pena, M.A.
• Julio Perez, MD
• Jeffrey M Pfeiffer, R.PH.
• Anh Phan

• Pediatrics Physician in Cocoa Beach, FL
• Providers in Cocoa Beach, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.