Brevard Psychiatry & Psychology Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

BREVARD PSYCHIATRY & PSYCHOLOGY INC

Practice address

6767 N Wickham Road
Suite 306
Melbourne, FL 32940

Phone

(321) 751-1925

Fax

(321) 751-9261

NPI assigned

Jan 10, 2007

Last updated

Jul 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jose Rafael Gonzalez-Soltero, MD

Title

Owner

Phone

(321) 751-1925

Specialties & licenses 4

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melinda L Poole, LMHC,CAP

  • Addiction (Substance Use Disorder) Counselor
  • Rockledge, FL
  • NPI 1225188634
  NPD (past)
• Nancy E Ryden, RN,LMHC

  • Mental Health Counselor
  • Rockledge, FL
  • NPI 1881744290
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1629128186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 N WICKHAM ROAD",
            "address_2": "SUITE 306",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "321-751-1925",
            "fax_number": "321-751-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 N WICKHAM ROAD",
            "address_2": "SUITE 306",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "321-751-1925",
            "fax_number": "321-751-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD PSYCHIATRY & PSYCHOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ-SOLTERO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "RAFAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-751-1925",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brevard Physical Therapy LLC
• Brevard Physician Associates, PLLC
• Brevard Physician Associates, PLLC
• Brevard Primary Care LLC
• Brevard Prosthetics & Orthotics, Inc
• Brevard Psychiatry LLC
• Brevard Psychiatry LLC
• Brevard Psychological Associates, Inc
• Brevard Regional Hyperbaric Center
• Brevard Rheumatology & Arthritis Center

• Psychiatry Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.