Brevard Physical Medicine

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

ME86688 Issued in FL

Legal business name

BREVARD PHYSICAL MEDICINE

Doing business as

Carnol Health Services

Practice address

6420 3Rd Street
Suite 103
Rockledge, FL 32955

Phone

(321) 751-5351

Fax

(321) 751-5370

NPI assigned

Apr 17, 2014

Organization subpart

No

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

Authorized official

Name

John Charles Madlener, M.D

Title

Medical Doctor

Phone

(321) 751-5351

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Carnol Health Services Doing business as

Locations

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1548680531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 3RD STREET",
            "address_2": "SUITE 103",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "32955",
            "telephone_number": "321-751-5351",
            "fax_number": "321-751-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 3RD STREET",
            "address_2": "SUITE 103",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "32955",
            "telephone_number": "321-751-5351",
            "fax_number": "321-751-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-17",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "MADLENER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "321-751-5351",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME86688",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267338000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carnol Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brevard Health Alliance Inc
• Brevard Hma HME, LLC
• Brevard Integrated Health Center LLC
• Brevard Neurology Associates PA
• Brevard Pharmacy L.L.C.
• Brevard Prosthetics & Orthotics, Inc
• Brevard Pulmonary Specialists PA
• Brevard Urology Associates PA
• Brevard Vascular Associates LLC
• Brevard Vision Center Inc

• Physical Medicine & Rehabilitation Physician in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.