NPIMap

Brevard Health Alliance

Organization Active NPI General Practice Physician · Melbourne, FL

NPI 1558088070 · NPPES record last updated Oct 25, 2022

Key facts

NPI
1558088070
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
Legal business name
BREVARD HEALTH ALLIANCE
Practice address
2550 Grant St Ste 137
Melbourne, FL 32901-6006
Phone
(321) 334-6940
Fax
(321) 334-6912
NPI assigned
Oct 25, 2022
Organization subpart
No

Authorized official

Name
Angela Craig
Title
Director of Billing
Phone
(321) 698-3446

Corporate family (same tax ID) 41

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

View all 41

National Provider Directory

Tax ID family
The Brevard Health Alliance Inc (42 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 208D00000X Yes

Addresses

Primary practice location

2550 Grant St Ste 137
Melbourne, FL 32901-6006

Mailing address

PO Box 1137
Melbourne, FL 32902-1137
Phone (321) 952-9696

Other identifiers

IdentifierTypeStateIssuer
688693129MedicaidFL

Other names

  • Heritage Park Doing business as

Other providers in Melbourne, FL

All providers in Melbourne, FL · General Practice Physician in Florida

Sources for this page

Verify at the official NPI Registry.